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Elizabeth M. Whitehorn, Director

Provider Notice issued 11/24/03

Changes in Billing Procedures Effective April 1, 2004

 

To:​ All Enrolled Providers​
Date:​ November 24, 2003​
Re:​ Changes in Billing Procedures Effective April 1, 2004​

 

The purpose of this notice is to communicate changes in the department’s billing procedures for certain laboratory procedures. 

 

Waived Lab Tests

 

Effective with dates of service on or after April 1, 2004, the department will accept Clinical Laboratory Improvement Amendments (CLIA) waived lab codes.  A listing of these codes is available on the Centers for Medicare and Medicaid Services (CMS) Web site at <http://www.cms.hhs.gov/>.  The QW modifier will be required when billing the department for a waived test.

Rapid Streptococcal Test

 

Effective April 1, 2004, the department will no longer accept CPT code 86588 for billing of rapid streptococcal tests.  Claims received with CPT code 86588 for dates of service on or after April 1, 2004, will be rejected.  Effective for dates of service on or after April 1, 2004, rapid streptococcal tests should be billed using CPT code 87880 with the QW modifier.  The reimbursement will remain $4.20. 

 

Any questions regarding this notice should be directed to the Bureau of Comprehensive Health Services at 217-782-5565.

 

Anne Marie Murphy, Ph.D.
Administrator
Division of Medical Programs