Oops they did it again!
ACE has been notified by several clients in different areas of the country that the new lab codes (CPT 80305, 80306 and 80307) are denying. In reviewing the 2017 Clinical Laboratory Fee Schedule for CMS, the code is listed but it does not appear on the fee schedule with the QW modifier, as it should when reporting a CLIA waived test. This is the reason that these codes are denying. ACE truly believes that this, like in other years, is an oversight on the part of CMS. We suggest that you notify your carriers of this error, keep track of all denials for this reason and once the error is rectified, you will need to follow the carrier’s instructions as to either resubmit the claims or do a bulk appeal.