US · guidance
CMS Pub. 100-04, ch. 16, § 70.6
Certificate for Provider-Performed Microscopy Procedures
Effective January 19, 1993, a laboratory that holds a certificate for provider-performed
microscopy procedures may perform only those tests specified as provider-performed
microscopy procedures and waived tests, as described below, and no others.
HCPCS
Code
Test
Q0111 Wet mounts, including preparations of vaginal, cervical or skin specimens
Q0112 All potassium hydroxide (KOH) preparations
Q0113 Pinworm examinations
Q0114 Fern test
Q0115 Post-coital direct, qualitative examinations of vaginal or cervical mucous
81015 Urinalysis; microscopic only
81000 Urinalysis, by dipstick or tablet reagent for bilirubin, glucose, hemoglobin,
ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any
number of these constituents; non-automated, with microscopy
81001 Urinalysis, by dipstick or tablet reagent for bilirubin, glucose, hemoglobin,
ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any
number of these constituents; automated, with microscopy (NOTE: May
only be used when the lab is using an automated dipstick urinalysis
instrument approved as waived.)
81020 Urinalysis; two or three glass test
89055 Fecal leukocyte examination
89190 Nasal smears for eosinophils
G0027 Semen analysis; presence and/or motility of sperm excluding Huhner
History
(Rev. 865, Issued: 02-17-06; Effective: 01-01-06; Implementation: 07-03-06)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
305cda1ac11d65978c37733e9dfd5c0e4080ef7d1b8aa5de597c6cb5d210d8fc
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