The new CMS code is G0477. It was activated on 1-1-16 and covers "read by direct optical observation" tests, such as dip strip drug tests or cups. You can submit one per date of service (I actually had a Dr. submitting 12 a day for a 12 panel UDS under the old code, and UHC was paying).

The CLIA waiver modifier, QW, is required, BUT there is a problem in the CMS system because they didn't link the QW modifier to the G0477 code, so if you submit G0477-QW it gets denied as "modifier not valid for date of service". My clearinghouse and AAPC recommend submitting G0477 without the QW modifier until after April 1st.


Pete
Practice Manager
Physician's Office Resource, Inc.