Two different practice models surround the conducting of laboratory tests: blood is drawn in the physician’s practice and the specimen is sent to an outside laboratory for analysis, or blood is drawn and laboratory tests are performed in the physician’s practice. A test performed in the office laboratory should be billed using the appropriate laboratory code and, if performed, the appropriate blood collection code.

Never report the laboratory code for a laboratory test that the practice does not run in-house or is not financially responsible for and is billed by the outside laboratory. In those cases, report only the blood draw and specimen handling, as appropriate.

Laboratories and physician offices performing waived tests may need to append modifier QW to the Current Procedural Terminology® code for Clinical Laboratory Improvement Amendments (CLIA)–waived procedures. The use of modifier QW is payer specific. To review the list of CLIA-waived procedures, go to...

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