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Official Description

Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening
Short Descr Oral hiv-1/hiv-2 screen
Coverage Carrier Priced
Pricing Indicator(s) 21 – Clinical Lab Fee Schedule - Price subject to national limitation amount
MPI A – Not applicable, as HCPCS priced under one methodology
Lab Cert(s) 140 – Virology
Processing Note SEE CHANGE REQUEST 6786.
BETOS T1H – Lab tests - other (non-Medicare fee schedule)
TOS Code(s) 9 – Other medical items or services
Added Date 12/8/2009
Status Code Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
CLIA Waived (QW) No
APC Status Indicator Service Paid under Fee Schedule or Payment System other than OPPS
MUE 1
MUE Not applicable/unspecified.
OTS Orthotic No
CCS Clinical Classification 233 - Laboratory - Chemistry and Hematology
GA Waiver of liability statement issued as required by payer policy, individual case
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
FP Service provided as part of family planning program
GZ Item or service expected to be denied as not reasonable and necessary
QW Clia waived test
Date
Action
Notes
2011-01-01 Changed CMS Quarterly update file had description of "Infectious agent detection by rapid antibody test of oral mucosa transudate, HIV-1 or HIV-2 screening". We changed our description changed to match the CMS FY 2011 File description.
2010-04-01 Added Implementation date.
2009-12-08 Added Effective date.
Code
Description
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