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Reimbursement Information

The CPT codes provided below are based on AMA coding guidelines and are for informational purposes only. Selection of appropriate codes is the sole responsibility of the billing party. Providers should check with their contracted payers for appropriate codes prior to submitting claims.

For any reimbursement related questions please e-mail reimb.support@quidel.com or call (800) 874-1517, option 2.

Rapid Diagnostics Coding Medicare Clin Lab Fee Schedule 2010
National Limit Amounts†
Pregnancy
QuickVue One-Step hCG Urine urine 81025 $9.06
QuickVue One-Step hCG Combo urine 81025 $9.06
 serum 84703 $10.76
QuickVue+ One-Step hCG Combo urine 81025 $9.06
 serum84703 $10.76
Influenza
QuickVue Influenza  87804QW* $17.18
QuickVue Influenza A+B**
If results for both Influenza A and Influenza B are ordered by practitioner Influenza A:
Influenza B:
 


87804QW*
87804QW*, 59



$17.18
$17.18
Respiratory Syncytial Virus
QuickVue RSV   87807QW* $17.18
Fecal Occult Blood
Medicare/Medicaid
QuickVue iFOB Diagnostic 82274QW* $22.78
QuickVue iFOB Screening G0328QW* $22.78
Private Insurance
QuickVue iFOB Diagnostic 82274 $22.78
QuickVue iFOB Screening 82274 $22.78
Strep A
QuickVue Dipstick Strep A 87880QW* $17.18
QuickVue In-Line Strep A 87880QW* $17.18
QuickVue+ Strep A 87880 $17.18
H. pylori
QuickVue H. pylori gIIserum/plasma86318 $18.54
  whole blood 86318QW* $18.54
Chlamydia
QuickVue Chlamydia 87810 $17.18
Bone Health
Metra DPD 82523 $26.77
Metra BAP 84080 $21.19

Important Notes:
† For state by state 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.

**Depending on individual payer coding policies, it is possible that certain payers will require one of the following coding scenarios:

  • Influenza A, Influenza B: 87804QW* reported with 2 units of service
  • Influenza A: 87804QW*, Influenza B: 87804QW*

Effective January 1, 2010, CPT 81025 DOES NOT require a QW modifier to be recognized as a waived test. Source: CMS Job Aid 6685

Under Federal and State law, it is the individual provider's 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.