If a lab test is billed and it does not match the level of Clinical Laboratory Improvement Amendment (CLIA) certification, we will let you know through a Smart Edit on your 277CA clearinghouse rejection report so you can respond- speeding up claims processing so you get paid faster. Please refer to the Smart Edits Homepage.
5 levels of CLIA certification:
Certificate of Waiver
Certificate for Provider-Performed Microscopy Procedures (PPMP)
The use of the QW modifier may be necessary when billing a CLIA waived test with Waiver or PPMP/Microscopy level certification. When there are situations like an Emergency Use Authorization (EUA), additional tests may be deemed as CLIA waived tests and also require the QW modifier.