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

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Bone Health
Test Name
CPT Code
LOINC Code
CPT Code Description
National Medicare Coverage

Medicare Reimbursement
MicroVue Calcitonin
82308
1992-7
Calcitonin
  CCI   MUE  
$ 26.79
MicroVue™ DPD
82523
27424-1
Collagen cross links, any method
  CCI   MUE   NCD
$ 18.68
MicroVue™ PYD
82523
34367-3
Collagen cross links, any method
  CCI   MUE   NCD
$ 18.68
MicroVue™ Intact PTH
83970
14866-8
Parathormone (parathyroid hormone)
  CCI   MUE  
$ 41.28
MicroVue™ BAP
84080
17838-4
Phosphatase, alkaline; isoenzymes
  CCI   MUE  
$ 14.78


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

Medicare Reimbursement
MicroVue™ C1-Inhibitor Plus
86161
66951-5
Complement; functional activity, each component
  CCI   MUE  
$ 12.00
MicroVue™ CIC-C1q
86161
27831-7
Complement; functional activity, each component
  CCI   MUE  
$ 12.00
MicroVue™ CIC-Raji
86161
47217-5
Complement; functional activity, each component
  CCI   MUE  
$ 12.00
MicroVue™ Bb Plus
86161
2269-9
Complement; functional activity, each component
  CCI   MUE  
$ 12.00
MicroVue™ CH50-Eq
86162
30131-7
Complement; total hemolytic (CH50)
  CCI   MUE  
$ 20.32




  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 03:39:08 3.239.50.33