This week we will review coding and payment policy for CLIA waived tests. Also, please note that CMS has corrected the travel allowance to collect specimens (HCPCS codes P9612 and P9615) from the previously stated $0.835/mile and $8.35 per one way trip to $0.825 and $8.25 respectively. As always, feel free to send us questions or suggestions for future Compliance Briefings.
Charles Root, Ph.D.
Medicare Reimbursement for CLIA Waived Tests
All laboratories must have one of the following CLIA certificates to legally perform clinical laboratory testing on specimens obtained from individuals in the United States.
Certificate of Waiver
Certificate for Provider Performed Microscopy (PPM) Procedures,
Certificate of Registration,
Certificate of Compliance, or
Certificate of Accreditation
Medicare edits all laboratory claims to ensure the provider submitting the claim has an appropriate CLIA certificate. A CLIA certificate number must be included on each laboratory claim. Laboratories with a certific....
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