Medicare CLIA waived CPT code list

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CLIA 1988 Waived Test Codes 

CLIA 1988 waived test codes have been assigned to the following simple tests commonly performed in physician offices and other locations. These tests are not subject to many of the regulatory requirements of the Clinical Laboratory Improvement Act of 1988.

  • 81002 URINALYSIS, DIPSTICK OR TABLET: (selected analytes); without microscopy, nonautomated
  • 81025 URINE PREGNANCY TEST: by visual color comparison methods
  • 82270 FECAL OCCULT BLOOD
  • 82962 BLOOD GLUCOSE: by glucose monitoring device(s) cleared by the Food and Drug Administration specifically for home use
  • 83026 HEMOGLOBIN: by copper sulfate method, nonautomated
  • 84830 OVULATION TESTS: by visual color comparison methods for human luteinizing hormone
  • 85013 SPUN MICROHEMATOCRIT
  • 8565 SEDIMENTATION RATE (ESR): nonautomated

Rather than continue to create new codes for each CLIA-waived product approved by the Food and Drug Administration, HCFA has chosen to use a modifier (QW) to designate waived tests. Payment, in general is the same as for the non-waived version of the same test. The following waived procedures are included in the 1998 laboratory fee schedule:

  • 80061QW LIPID PANEL
  • 81001QW URINALYSIS: automated dipstick, with microscopy
  • 81002QW URINALYSIS: automated dipstick without microscopy
  • 82044QW MICROALBUMIN: urine, semiquantitative (reagent strip)
  • 82273QW OCCULT BLOOD: other sources, qualitative
  • 82465QW CHOLESTEROL: serum, total
  • 82947QW GLUCOSE: quantitative
  • 82950QW GLUCOSE, POST GLUCOSE DOSE: including glucose
  • 82951QW GLUCOSE TOLERANCE TEST: 3 specimens including glucose
  • 82952QW GLUCOSE TOLERANCE TEST: each additional specimen beyond 3
  • 82985QW GLYCATED PROTEIN
  • 83718QW LIPOPROTEIN, HDL CHOLESTEROL: direct measurement
  • 83986QW pH BODY FLUID: except blood
  • 84478QW TRIGLYCERIDES
  • 85014QW BLOOD COUNT, HEMATOCRIT: other than spun
  • 85018QW BLOOD COUNT, HEMOGLOBIN
  • 85610QW PROTHROMBIN TIME
  • 86318QW IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY: qualitative, one step
  • 6588QW STREPTOCOCCUS: direct screen
  • 87072QW CULTURE OR DIRECT BACTERIAL ID: each organism, by commercial kit, other than urine