Author Topic: CLIA  (Read 928 times)

midwifebiller

  • Full Member
  • ***
  • Posts: 154
CLIA
« on: March 03, 2010, 10:15:24 AM »
I need to talk with someone who knows the nitties and gritties of the CLIA requirements. Specifically, the difference between waived tests and PPM.  Is anyone available??

Thanks.
Kelli
Kelli Sugihara, CPMB
Midwife Billing & Business, LLC
www.midwifebilling.com

midwifebiller

  • Full Member
  • ***
  • Posts: 154
Re: CLIA
« Reply #1 on: March 04, 2010, 01:43:58 PM »
No takers, yet.  OK, here is a specific example.

A midwife needs to perform a glucose tolerance test (GTT) in her office to screen for gestational diabetes.  She has a glucometer (FDA approved for home use), draws blood from a vein (not a finger stick) and performs the GTT per standard protocol.  Is this a CLIA waived test or is does this test require a PPM certificate in order to send a claim to the insurance company?

[The uproar on the midwives' Yahoo group regarding this issue is quite impressive.  I would like to be able to offer some documented assistance.]

Thank you!
Kelli Sugihara, CPMB
Midwife Billing & Business, LLC
www.midwifebilling.com

medauthor

  • Full Member
  • ***
  • Posts: 130
    • Professional Medical Billers Association
Re: CLIA
« Reply #2 on: March 04, 2010, 09:15:14 PM »
Kelli,

Look on the CMS website and enter the code and you can see if it is a CLIA waived test  :)
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections