MA120: Missing/incomplete/invalid CLIA certification number

CLIA (Clinical Laboratory Improvement Amendments) 1998

1. Entities that perform clinical laboratory tests need to obtain certification through the state department of health.
2. CLIA number must be submitted on claims for clinical laboratory tests, including tests that are classified as ‘CLIA-waived.
3. For paper claims, submit the CLIA certification number in Item 23 of the CMS-1500 claim form.,
4. The Food and Drug Administration (FDA) determines which laboratory tests are waived.
5. Please note that not all CLIA-waived tests require HCPCS modifier QW.
6. Claims that are missing required CLIA certification numbers are rejected as ‘billing errors’ and must be submitted as new claims.
7. . The CLIA certification number provided on the claim form must match the official records maintained by CMS.

CLIA Denial:

• MA120: Missing/incomplete/invalid CLIA certification number.

• MA130: Your claim contains incomplete and/or invalid information, and no appeal rights 
are afforded because the claim is unprocessable. Please submit a new claim with the complete/correct 
information.