CMS has announced the addition of four codes with modifiers that are subject to Clinical Laboratory Improvement Amendments (CLIA) edits.
The HCPCS codes listed below were new in 2011, are subject to CLIA edits and were not mentioned in prior change requests. The HCPCS codes listed below require a facility to have either a CLIA certificate of registration (certificate type code 9), a CLIA certificate of compliance (certificate type code 1) or a CLIA certificate of accreditation (certificate type code 3). A facility without a valid, current, CLIA certificate, with a current CLIA certificate of waiver (certificate type code 2) or with a current CLIA certificate for provider-performed microscopy procedures (certificate type code 4) must not be paid for these tests.
|
HCPCS |
Modifier |
Description |
|
88120 |
TC |
Cytopathology, in situ hybridization (e.g., FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual |
|
88120 |
26 |
Cytopathology, in situ hybridization (e.g., FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual |
|
88121 |
TC |
Cytopathology, in situ hybridization (e.g., FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology |
|
88121 |
26 |
Cytopathology, in situ hybridization (e.g., FISH), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology |
The official instruction (CR7513) issued to your carrier and/or A/B MAC regarding this change may be viewed at www.cms.gov/Transmittals/downloads/R915OTN.pdf.
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