2021 Coding Reference

For questions, please contact CodeMap Reimbursement Support at (312) 291-8408
or email quidel@codemap.com

Rapid & Molecular Reimbursement Summary

The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the payment adjustment percentage of 2% applied to all Medicare Fee-For-Service (FFS) claims from May 1 through December 31. The Consolidated Appropriations Act, 2021, signed into law on December 27, extends the suspension period to March 31, 2021. An Act to Prevent Across-the-Board Direct Spending Cuts, and for Other Purposes, signed into law on April 14, 2021, extends the suspension period to December 31, 2021.
Click here for more information.



Rapid Diagnostics

Molecular Diagnostics

Cell Culture & Fluorescent Tests

ELISA
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Refer to the Quidel Cell Culture and Fluorescent Test Reimbursement Manual for additional coding recommendations for each assay depending on testing and results.

Cell Culture & Fluorescent Tests Download this page as PDF

Chlamydia
Test Name
CPT Code
LOINC Code
CPT Code Description
National Medicare Coverage

Medicare Reimbursement
D3 DFA Chlamydiae Culture Confirmation Kit
87110
561-1
Culture, chlamydia, any source
  CCI   MUE   NCD
$ 19.60
D3 DFA Chlamydiae Culture Confirmation Kit
87140
561-1
Culture, typing; immunofluorescent method, each antiserum
  CCI   MUE  
$ 5.57


Enterovirus
Test Name
CPT Code
LOINC Code
CPT Code Description
National Medicare Coverage

Medicare Reimbursement
D3 IFA Enterovirus Identification Kit
87254
43364-9
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56


Herpes
Test Name
CPT Code
LOINC Code
CPT Code Description
National Medicare Coverage

Medicare Reimbursement
ELVIS® HSV Identification and D3 Typing Test System
87140
5853-7
Culture, typing; immunofluorescent method, each antiserum
  CCI   MUE  
$ 5.57
ELVIS® HSV Identification and D3 Typing Test System
87140 - 59
5853-7
Culture, typing; immunofluorescent method, each antiserum
  CCI   MUE  
$ 5.57
D3 DFA Herpes Simplex Virus Identification Kit
87254
5855-2
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
D3 DFA Herpes Simplex Virus Identification and Typing Kit
87254
5857-8
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
D3 DFA Cytomegalovirus Immediate Early Antigen Identification Kit
87254
43707-9
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
D3 DFA Varicella-zoster Virus Identification Kit
87254
10860-5
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
D3 DFA Herpes Simplex Virus Identification and Typing Kit
87254 - 59
43695-6
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
ELVIS® HSV Identification Test System
87255
43695-6
Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity)
  CCI   MUE  
$ 33.86
ELVIS® HSV Identification and D3 Typing Test System
87255
43695-6
Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity)
  CCI   MUE  
$ 33.86


Respiratory
Test Name
CPT Code
LOINC Code
CPT Code Description
National Medicare Coverage

Medicare Reimbursement
D3 DFA Metapneumovirus Identification Kit
87254
88222-5
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
D3 Duet™ DFA Influenza A/Respiratory Virus Screening Kit
87254
80204-1
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
D3 Duet™ DFA RSV/Respiratory Virus Screening Kit
87254
50024-9
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
D3 Ultra™ DFA Respiratory Virus Screening and Identification Kit
87254
88909-7
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
D3 Duet™ DFA Influenza A/Respiratory Virus Screening Kit
87254 - 59
80204-1
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
D3 Duet™ DFA RSV/Respiratory Virus Screening Kit
87254 - 59
5877-6
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
D3 Ultra™ DFA Respiratory Virus Screening and Identification Kit
87254 - 59
88909-7
Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus
  CCI   MUE  
$ 19.56
D3 Duet™ DFA Influenza A/Respiratory Virus Screening Kit
87260
43610-5
Infectious agent antigen detection by immunofluorescent technique; adenovirus
  CCI   MUE  
$ 14.43
D3 Duet™ DFA RSV/Respiratory Virus Screening Kit
87260
5834-7
Infectious agent antigen detection by immunofluorescent technique; adenovirus
  CCI   MUE  
$ 14.43
D3 FastPoint™ L-DFA Respiratory Virus Identification Kit
87260
5834-7
Infectious agent antigen detection by immunofluorescent technique; adenovirus
  CCI   MUE  
$ 14.43
D3 Ultra™ DFA Respiratory Virus Screening and Identification Kit
87260
5834-7
Infectious agent antigen detection by immunofluorescent technique; adenovirus
  CCI   MUE  
$ 14.43
D3 Duet™ DFA Influenza A/Respiratory Virus Screening Kit
87275
5867-7
Infectious agent antigen detection by immunofluorescent technique; influenza B virus
  CCI   MUE  
$ 12.25
D3 FastPoint™ L-DFA Respiratory Virus Identification Kit
87275
5867-7
Infectious agent antigen detection by immunofluorescent technique; influenza B virus
  CCI   MUE  
$ 12.25
D3 Duet™ DFA RSV/Respiratory Virus Screening Kit
87275
5867-7
Infectious agent antigen detection by immunofluorescent technique; influenza B virus
  CCI   MUE  
$ 12.25
D3 FastPoint™ L-DFA Influenza A/Influenza B Virus Identification Kit
87275
5867-7
Infectious agent antigen detection by immunofluorescent technique; influenza B virus
  CCI   MUE  
$ 12.25
D3 Ultra™ DFA Respiratory Virus Screening and Identification Kit
87275
5867-7
Infectious agent antigen detection by immunofluorescent technique; influenza B virus
  CCI   MUE  
$ 12.25
D3 Duet™ DFA Influenza A/Respiratory Virus Screening Kit
87276
5863-6
Infectious agent antigen detection by immunofluorescent technique; influenza A virus
  CCI   MUE  
$ 16.07
D3 FastPoint™ L-DFA Respiratory Virus Identification Kit
87276
5863-6
Infectious agent antigen detection by immunofluorescent technique; influenza A virus
  CCI   MUE  
$ 16.07
D3 Duet™ DFA RSV/Respiratory Virus Screening Kit
87276
5863-6
Infectious agent antigen detection by immunofluorescent technique; influenza A virus
  CCI   MUE  
$ 16.07
D3 FastPoint™ L-DFA Influenza A/Influenza B Virus Identification Kit
87276
5863-6
Infectious agent antigen detection by immunofluorescent technique; influenza A virus
  CCI   MUE  
$ 16.07
D3 Ultra™ DFA Respiratory Virus Screening and Identification Kit
87276
5863-6
Infectious agent antigen detection by immunofluorescent technique; influenza A virus
  CCI   MUE  
$ 16.07
D3 Duet™ DFA Influenza A/Respiratory Virus Screening Kit
87279
13327-2
Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type
  CCI   MUE  
$ 16.43
D3 Duet™ DFA RSV/Respiratory Virus Screening Kit
87279
13327-2
Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type
  CCI   MUE  
$ 16.43
D3 Ultra™ DFA Respiratory Virus Screening and Identification Kit
87279
13327-2
Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type
  CCI   MUE  
$ 16.43
D3 Duet™ DFA Influenza A/Respiratory Virus Screening Kit
87279 - 59
13327-2
Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type
  CCI   MUE  
$ 16.43
D3 Duet™ DFA RSV/Respiratory Virus Screening Kit
87279 - 59
13327-2
Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type
  CCI   MUE  
$ 16.43
D3 Ultra™ DFA Respiratory Virus Screening and Identification Kit
87279 - 59
13327-2
Infectious agent antigen detection by immunofluorescent technique; Parainfluenza virus, each type
  CCI   MUE  
$ 16.43
D3 Duet™ DFA Influenza A/Respiratory Virus Screening Kit
87280
5877-6
Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus
  CCI   MUE  
$ 13.42
D3 Duet™ DFA RSV/Respiratory Virus Screening Kit
87280
5877-6
Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus
  CCI   MUE  
$ 13.42
D3 FastPoint™ L-DFA Respiratory Virus Identification Kit
87280
5877-6
Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus
  CCI   MUE  
$ 13.42
D3 FastPoint™ L-DFA RSV/MPV Virus Identification Kit
87280
5877-6
Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus
  CCI   MUE  
$ 13.42
D3 Ultra™ DFA Respiratory Virus Screening and Identification Kit
87280
5877-6
Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus
  CCI   MUE  
$ 13.42
D3 FastPoint™ L-DFA Respiratory Virus Identification Kit
87299
Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism
  CCI   MUE  
$ 16.10
D3 FastPoint™ L-DFA RSV/MPV Virus Identification Kit
87299
Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism
  CCI   MUE  
$ 16.10
D3 DFA Metapneumovirus Identification Kit
87299
Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism
  CCI   MUE  
$ 16.10
D3 Duet™ DFA Influenza A/Respiratory Virus Screening Kit
87300
Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum
  CCI   MUE  
$ 11.98
D3 Duet™ DFA RSV/Respiratory Virus Screening Kit
87300
Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum
  CCI   MUE  
$ 11.98
D3 FastPoint™ L-DFA Respiratory Virus Identification Kit
87300
Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum
  CCI   MUE  
$ 11.98
D3 Ultra™ DFA Respiratory Virus Screening and Identification Kit
87300
Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum
  CCI   MUE  
$ 11.98


Thyroid
Test Name
CPT Code
LOINC Code
CPT Code Description
National Medicare Coverage

Medicare Reimbursement
Thyretain® TSI Reporter BioAssay
84445
17708-9
Thyroid stimulating immune globulins (TSI)
  CCI   MUE  
$ 50.86




  For Medicare Clinical Laboratory Fee Schedule, go to www.cms.hhs.gov.

*QW modifier is added to report use of CLIA-waived test system(s) for Medicare/Medicaid claims.

CMS has set the effective date for the addition of the QW modifier with 87420 and 87430 as October 6, 2020 and an implementation date of July 6, 2021. That means Medicare/Medicaid have until July 6, 2021 to update their systems to accept the QW modifier with these codes. We recommend customers check with their payers prior to submitting claims to verify if their system has been updated.

Effective January 1, 2010, CPT 81025 DOES NOT require a QW modifier to be recognized as a waived test. Source: CMS Job Aid 6685.

This information is being provided as a reference, for informational purposes only, with no expressed or implied warranty and does not purport to provide legal or certified coding advice. Under Federal and State law, it is the individual providerÕs responsibility to determine appropriate coding, charges and claims for a particular service. Policies regarding appropriate coding and payment levels can vary greatly from payer to payer and change over time. Quidel Corporation strongly recommends that providers contact their contracted payers to determine appropriate coding and charge or payment levels prior to submitting claims.

This website is a private website and is not associated, endorsed or authorized by the Department of Health and Human Services, the Center for Medicare and Medicaid Services or any other public or government organization or agency.



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10/17/2021 04:38:15 3.239.50.33