CLIA Waived Tests and CPT Codes

1 Waived Tests and CPT Codes This list is for informational purposes only and may not accurately represent current CMS CPT Codes . Please verify your Tests Waived status and CPT code prior to implementing testing. Approved Test Name/Specific Test System Manufacturer CPT. Code(s). Adenovirus AdenoPlus (human eye fluid) Rapid Pathogen Screening, Inc. 87809QW. Rapid Pathogen Screening RPS Adeno Detector Rapid Pathogen Screening, Inc. 87809QW. Aerobic/Anaerobic Organisms - Vaginal Genzyme Diagnostics OSOM BVBLUE Test Gryphus Diagnostics, LLC 87905QW. Gryphus Diagnostics BVBlue Gryphus Diagnostics, LLC 87905QW. OBGYN-Vph Vaginal Ph Screening Kit Teco Diagnostics Pending Aerobic/Anaerobic/Viral Panel - Respiratory FilmArray Respiratory Panel EZ (RP EZ) (nasopharyngeal) Biofire Diagnostics, LLC Pending Albumin Abaxis Piccolo Blood Chem Analyzer WB (Chem 13, CMP, Renal) Abaxis, Inc 82040QW.

2 Abaxis Piccolo Point of Care Chemistry Analyzer (Liver Panel Plus Abaxis, Inc. 82040QW. Reagent Disc). Abaxis Piccolo xpress Chem Analyzer WB. Abaxis, Inc 82040QW. (Chem 13, CMP, Liver Panel Plus, Renal). Arkray SPOTCHEM EZ Chem Analyzer (WB) Polymedco, Inc 82040QW. Genzyme Diag OSOM ImmunoDip (urinary alb) Genzyme Diagnostics 82040QW. HemoCue Albumin 201 System (urinary albumin) HemoCue AB 82040QW. Alanine Aminotransferase (ALT). Abaxis Piccolo Blood Chem Analyzer WB (CMP, Chem 6, Chem Abaxis, Inc 84460QW. 13). Abaxis Piccolo Point Of Care Chemistry Analyzer (Lipid Panel Abaxis, Inc. 84460QW. Reagent Disc) ALT. Abaxis Piccolo xpress Chem Analyzer WB(CMP, Lipid Panel Plus, Abaxis, Inc 84460QW.)

3 Liver Panel Plus, Chem 6, Chem 13). Alere Cholestech LDX (ALT)(WB) Alere, Inc 84466QW. Arkray SPOTCHEM EZ Chem Analyzer (WB) Arkray, Inc. / Polymedco, Inc 84460QW. Cholestech LDX Alanine Aminotransferase (ALT) Cholestech Corporation 84460QW. Alkaline Phosphatase (ALP). Abaxis Piccolo Blood Chem Analyzer WB (CMP, Chem 13) Abaxis, Inc 84075QW. Abaxis Piccolo Point of Care Chemistry Analyzer (Liver Panel Plus Abaxis, Inc. 84075QW. Reagent Disc) (WB). Abaxis Piccolo xpress Chem Analyzer WB (CMP, Chem 13, Liver Abaxis, Inc 84075QW. Panel Plus). Akray SPOTCHEM EZ Chem Analyzer (WB) Polymedco, Inc 84075QW. Amylase Abaxis Piccolo Blood Chem Analyzer WB (Chem 13) Abaxis, Inc 82150QW.

4 Abaxis Piccolo express Chemistry Analyzer WB (Liver Panel Plus, Abaxis, Inc 82150QW. Chem 13). Abaxis Piccolo Point of Care Chemistry Analyzer (Liver Panel Plus Abaxis, Inc. 82150QW. Reagent Disc)(WB). Aspartate Aminotransferase (AST). Abaxis Piccolo Blood Chem Analyzer WB (Chem 6, Chem 13, Abaxis, Inc 84450QW. CMP). DOH 681-018 April 2017 Page 1 of 47. Approved Test Name/Specific Test System Manufacturer CPT. Code(s). Abaxis Piccolo Point Of Care Chemistry Analyzer (Liver Panel Abaxis, Inc. 84450QW. Reagent Disc) AST (WB). Abaxis Piccolo xpress Chem Analyzer WB(Chem 6, Chem 13, Abaxis, Inc 84450QW. CMP, Liver Panel Plus, Lipid Panel Plus). Arkray SPOTCHEM EZ Chem Analyzer (WB) Arkray, Inc.

5 / Polymedco, Inc 84450QW. Cholestech LDX Aspartate Aminotransferase Cholestech Corporation 84450QW. B-Type Natriuretic Peptide (BNP). Biosite Triage Meter (WB) (BNP) Biosite Incorporated 83880QW. Biosite Triage Meter Plus (WB)(BNP) Biosite Incorporated 83880QW. Biosite Triage Meterpro (WB)(BNP) Biosite Incorporated 83880QW. Basic Metabolic Panel (Calcium, Ionized). Abbott i-STAT CHEM8+ Cartridge WB I-STAT Corporation 80047QW. Basic Metabolic Panel (Calcium, Total). Abaxis Piccolo Blood Chemistry Analyzer WB (Basic Metabolic Abaxis, Inc 80048QW. Reagent Disc). Abaxis Piccolo xpress Chemistry Analyzer WB (Basic Metabolic Abaxis, Inc 80048QW. Reagent Disc).

6 Bilirubin, Total Abaxis Piccolo Blood Chem Analyzer WB (Chem 13, CMP) Abaxis, Inc 82247QW. Abaxis Piccolo Point of Care Chemistry Analyzer (Liver Panel Plus Abaxis, Inc. 82247QW. Reagent Disc)(WB). Abaxis Piccolo xpress Chem Analyzer WB(Chem 13, CMP, Liver Abaxis, Inc 82247QW. Panel Plus). Akray SPOTCHEM EZ Chem Analyzer (WB) Polymedco, Inc 82247QW. Bladder Tumor Associated Antigen Alere NMP22 BladderChek Test Alere 86386QW. BTA stat Test (for home use) Bion Diagnostic Sciences 86294QW. LifeScan Status BTA Polymedco, Inc 86294QW. Maritech BladderCheck Maritech, Inc. 86386QW. BUN (Blood Urea Nitrogen). Abaxis Piccolo Blood Chemistry Analyzer (Chem 6 and 13 Panels, Abaxis, Inc.)

7 84520QW. CMP, BMP, Metlyte 8, Renal). Abaxis Piccolo xpress Chemistry Analyzer WB (Chem 6, 13, Abaxis, Inc. 84520QW. Kidney Panels, CMP, BMP, Metlyte 8, Renal). Abbott i-STAT 6+ Cartridge (WB) i-STAT Corporation 84520QW. Abbott i-STAT CHEM8+ Cartridge (WB) i-STAT Corporation 84520QW. Arkray SPOTCHEM EZ Chem Analyzer (WB) Arkray, Inc. 84520QW. Calcium Abaxis Piccolo Blood Chemistry Analyzer WB (Chem 13 Panel, Abaxis, Inc. 82310QW. CMP, BMP, Renal). Abaxis Piccolo xpress Chemistry Analyzer WB (Chem 13 Panel, Abaxis, Inc. 82310QW. CMP, BMP, Renal). Arkray SPOTCHEM EZ Chem Analyzer (WB) Polymedco, Inc 82310QW. Calcium Ionized Abbott i-STAT CHEM8+ Cartridge (WB) i-STAT Corporation 82330QW.

8 Carbon Dioxide (CO2). Abaxis Piccolo Blood Chemistry Analyzer (CMP, BMP, Electrolyte Abaxis, Inc 82374QW. Discs, Metlyte 8, Renal). DOH 681-018 April 2017 Page 2 of 47. Approved Test Name/Specific Test System Manufacturer CPT. Code(s). Abaxis Piccolo xpress Chemistry Analyzer (CMP, BMP, Electrolyte Abaxis, Inc 82374QW. Discs, Metlyte 8, Renal). Abbott i-STAT CHEM8+ Cartridge (WB) i-STAT Corporation 82374QW. Catalase Accutest Uriscreen Rapid UTI Screen Savyon Diagnostics 81007QW. Uriscreen (for OTC use), urine Diatech Diagnostics 81007QW. Chloride Abaxis Piccolo Blood Chemistry Analyzer (CMP, BMP, Electrolyte, Abaxis, Inc 82435QW. Metlyte 8, Renal). Abaxis Piccolo xpress Chemistry Analyzer (CMP, BMP, Abaxis, Inc 82435QW.)

9 Electrolyte, Metlyte 8, Renal). Abbott i-STAT 6+ Cartridge (WB) i-STAT Corporation 82435QW. Abbott i-STAT CHEM8+ Cartridge (WB) i-STAT Corporation 82435QW. Cholesterol Abaxis Piccolo xpress Chemistry Analyzer {capillary-finger stick}. Abaxis, Inc 82465QW. (Cholesterol). Abaxis Piccolo xpress Chemistry Analyzer WB (Lipid Panel, Lipid Abaxis, Inc 82465QW. Panel Plus). Abaxis Piccolo Point of Care Chemistry Analyzer WB (Lipid Panel, Abaxis, Inc 82465QW. Lipid Panel Plus). Accu-Check InstantPlus Cholesterol Test System Roche/Boehringer Mannheim 82465QW. Accucheck Instant Plus Dual Testing System Roche Diagnostics 82465QW. Advanced Care Cholesterol Measuring System Johnson & Johnson 82465QW.

10 Alere Cholestech LDX (cholesterol)(WB) Alere, Inc 84465QW. Arkray SPOTCHEM EZ Chem Analyzer (WB) Polymedco, Inc 82465QW. Biomedix Inc Q Steps Biometer G/C Dual Monitoring System Biomedix, Inc. 82465QW. ChemTrak AccuMeter Cholesterol Test System ChemTrak 82465QW. Cholestech LDX (Must have software version or above) Cholestech 82465QW. Total Cholesterol & PDU ActiMed Laboratories, Inc 82465QW. Infopia USA LipidPro Infopia Co Ltd 82465QW. Infopia USA LipidPro Professional Lipid Profile and Glucose Infopia Co Ltd 82465QW. Measuring System Jant Pharmacal LipidPlus Lipid Profile and Glucose Measuring Infopia Co, Ltd 82465QW. System Lifestream Plus Cholesterol Monitor Lifestream Technologies 82465QW.