Forum - Questions & Answers
80104 and CLIA
Question:
We use a G0434 QW for Medicare billing for our drug testing done in the office, but we are told to use a 80104 QW for commercial payers. We have had our commercial payers deny, stating the QW is not a valid modifier for the 80104 code. I looked at the CLIA waived test list on the CMS website, and 80104 is not listed. However, G0434 is. If 80104 is not listed, what does this mean for our office performing this test on our patients, if it is not considered a CLIA waived test? Isn't G0434 and 80104 the same code, just one is for Medicare billing and one is for commercial. Help?
re: 80104 and CLIA
I also just went throug the CMS website, and it did state that new codes are G0434 and the crosswalk new code is 80104..so this is a bit confusing..maybe you can call and ask them?
re: 80104 and CLIA
Do you use the single strips/dipped in urine for Medicare?