Waived Test Menu
|
|
TEST (CPT CODE) |
DEVICE/TEST KIT |
USAGE |
PURPOSE |
|
Blood Glucose (82962) |
Roche
Accuchek Inform
Roche
Accudata GTS/GTS Plus
Roche
Advantage
Bayer
Contour |
Screening and
Monitoring |
Monitoring of blood glucose levels |
|
CLOtest (87077QW) |
Delta
West CLOtest (TriMed) |
Screening |
Presumptive identification of H. pylori
in gastric biopsy tissue |
|
Creatinine (82565QW) |
Abbott i-Stat
CREA Cartridge |
Screening |
Quantitative measurement of creatinine
in whole blood |
|
Fecal Occult Blood
(82270; 82272 ) |
Helena
Coloscreen
Smith-KleinDiagnostics Hemoccult
PSS
Select Occult Blood Test (Helena) |
Screening |
Detection of blood in feces (colorectal
cancer screening) |
|
HCG (Urine) (81025) |
Wampole
Signify
StanBio
True
Genzyme
Contrast
Genzyme
Card |
Diagnostic |
Diagnosis of pregnancy by Visual color
comparison |
|
Hemoglobin (85018QW) |
HemoCue
HemoCue
201+
HemoPoint H2 |
Screening and
Diagnostic |
Measures hemoglobin level in whole blood |
|
Hemoglobin A1C (83036QW) |
Siemens
DCA 2000
Siemens
DCA Vantage
|
Monitoring |
Monitoring the long-term care of people
with diabetes |
|
Lipid Profile
(80061QW,
82465QW 83718QW, 84460QW, 84478QW)
AST
(84450QW) |
Cholestech LDX |
Monitoring |
Measures total
cholesterol, HDL, Triglycerides, and ALT in whole blood.
Quantitative
determination of AST in whole blood. |
|
Microalbumin (82044QW, 82570QW)
|
Bayer
Diagnostics/ MICROALBUSTIX™
|
Screening |
Semi-quantitative measurement of
microablumin in urine for the detection of patients at risk for
developing kidney damage |
|
pH - Body Fluids (83986QW) |
Various |
Screening |
pH detection in body fluids |
|
Prothrombin Time
(85610QW) |
Roche
Coachuchek XS |
Screening and
Monitoring |
Screening for congenital deficiencies of
Factors II, V, VII, X; screen for deficiency of prothrombin;
evaluate heparin, coumadin or warfarin effect; screen for Vitamin K
deficiency |
|
Rapid Influenza (87804QW) |
Quidel
QuickVue:
Influenza
A+B
Influenza A and B |
Screening and Diagnostic |
Qualitative detection of influenza type
A and type B antigens from nasal specimens |
|
Spun Microhematocrit
(85013) |
Microhematocrit centrifuge
Separation Technologies HemataCheck |
Screening |
Screen or diagnose anemia |
|
Strep A (87880QW) |
Genzyme
OSOM Ultra |
Screening and
Diagnostic |
Aid in the diagnosis of strep throat,
tonsillitis |
|
UA Dipstick (81002) |
Roche
Chemstrip SG
Siemens
Multistix 10SG
Roche
Chemstrip® Micral Test Strips
Bayer
Clinitest ™ Tablets |
Screening |
Monitor/diagnose various
diseases/conditions, such as diabetes, the state of the kidney or
urinary tract, and urinary tract infections |
|
UA Dipstick - Bilirubin
(81003QW) |
Bayer
Clinitek 50 |
Screening |
Screening for diseases and conditions,
such as diabetes, the state of the kidney or urinary tract, and
urinary tract infections |
PROVIDER PERFORMED MICROSCOPY
PROCEDURES (PPMP)
|
PROCEDURE (CPT CODE)
|
INSTRUMENT
|
DIAGNOSTIC
|
|
Fecal Leukocytes (89055) |
Brightfield microscope |
Detection of WBC’s in feces smears provides useful information prior to
the isolation of the etiological agent which can take hours to isolate. |
|
Fern Test (Q0114) |
Brightfield microscope |
To
detect premature leakage of amniotic fluid from fetal membranes |
|
KOH Preps (Q0112) |
Brightfield or Phase
microscope |
Positive result
indicates fungal infection. |
|
Nasal Smear (89190) |
Brightfield microscope |
Presence of eosinophils |
|
Pinworm Ova (Q0113) |
Brightfield microscope |
Diagnosis of seatworm or
pinworm causing human enterobiasis or oxyuriasis |
|
Post-coital direct
(Q0115) |
Brightfield microscope |
Qualitative examination
of vaginal or cervical mucous |
|
Semen Analysis (G0027) |
Brightfield or phase
microscope |
Presence and/or motility
of sperm, including Huhner |
|
Urinalysis by dipstick
or tablet reagent, non-automated, with microscopy (81000) |
Brightfield or phase
microscope |
Diagnosis of infections
and renal glomerular and tubular diseases |
|
Urinalysis, microscopic
only (81005) |
Brightfield or phase
microscope |
Diagnosis of infections
and renal glomerular and tubular diseases |
|
Wet mounts
(Q0111) |
Brightfield microscope |
Diagnosis of some
infections such as Trichomonas |
|
MODERATE COMPLEXITY TESTS
(Tests performed under Pathology Clinical
Services CLIA and CAP) |
|
TEST |
DEVICE/TEST KIT |
USAGE |
PURPOSE |
|
ACT |
ITC Hemochron 401
ITC Hemochron
801
ITC Hemochron Response
|
Monitoring |
Used to monitor heparin therapy and
adjust heparin dosage |
|
Clinitest (stool) |
Bayer Clinitest ™ Tablets |
Screening |
Screening for several abnormalities,
such as glycosuria, other reducing sugars or substances, etc. |
|
Co-ox Panel |
AVOX 4000 |
Monitoring |
Used in the assessment of oxygen
transport. |
