Q/A: What Codes do I use for CLIA-Waived Tests?

Question:

I am a certified DOT medical examiner and have applied to get my CLIA lab (waiver) for urinalysis, finger prick blood tests for A1c, cholesterol and glucose. I realize I cannot diagnose patients with these tests, but I am using them to make decisions in the DOT process and with nutritional counseling. What codes do I use for these tests?

Answer:

You may want to double check with the manufacturer of the device(s) you are using since they likely have done the research already and know which codes are applicable. CLICK HERE for an example of a fact sheet by one manufacturer.

Some other possibilities are:

  • Blood glucose: 82962 - Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use
  • A1C: 83037 - Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use

There are some payers that will also pay for the collection of the blood (code 36416) in addition to the laboratory testing service, but others consider it inclusive to the procedure so you'll have to see what your payer allows.

Author: 
Wyn, Director of Research