Billing Coding for Presumptive Drug Class Procedures, UDS, Urinary Drug Screening and Immunoassay

*** 2017 NEW CPT CODES FOR URINE DRUG SCREENING – READ AND CLICK HERE!

An Article on – Billing Coding for Urinary Drug Screening, Presumptive Drug Class Procedures, UDS, Urinary Drug Screening and Immunoassay

billing coding for urinary drug screening, immunoassay testing

 

Understanding Presumptive Drug Class procedures:

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These are procedures that are used and performed in order to identify the possible use of a drug or drug class (eg., narcotics and controlled drug substances). A presumptive test may be followed by a definitive test in order to specifically identify drugs or metabolites.

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Effective January 01, 2015

Your qualitative Drug Screening Codes (80100, 80101 and 80104) have been deleted!

Let’s look at your new CPT Codes for 2015:

80300 – Drug screen, any number of drug classes from Drug Class List A; any number of non-TLC devices or procedures (e.g., immunoassay) capable of being read by direct optical observation, including instrumented-assisted when performed (e.g.. Dipsticks, cups, cards, cartridges) per date of service
**** ONLY report once, regardless of the number of drug class per date of service

80301 – single drug class methods, by instrumented test systems (e.g. Discrete multichannel chemistry analyzers utilizing immunoassay or
2 enzyme assay), per date of service
**** Report ONLY once for a single or multiple procedures performed, regardless of the number of performed, classes or results on any date of service

80302 – Drug screen, presumptive, single drug class from Drug Class List B, by immunoassay (e.g. ELISA) or non-TLC chromatography without mass spectrometry (e.g. GC, HPLC), each procedure
**** Report each drug class once per date of service

80303 – Drug screen, any number of drug classes, presumptive, single or multiple drug class method; thin layer chromatography procedure(s) (TLC) (e.g. Acid, neutral, alkaloid plat), per date of service
**** Report single or multiple drug procedures, once per day of service

80304 – not otherwise specified presumptive procedure (e.g. TOF, MALDI, LDTD, DESI, DART), each procedure
**** Report single or multiple drug screenings, per testing site, per date of service, per each procedure

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For your Medicare Beneficiaries, use the following HCPCS Codes:

NEW 2016 CPT CODING FOR URINARY DRUG SCREENING

(G0431 AND G0434 HAVE BEEN DELETED DECEMBER 2015)

CLICK HERE FOR 2016 CPT CODE FOR URINARY DRUG SCREEN TESTING

G0431 (DELETED 2016) – Drug screen, qualitative; multiple drug classes by high complexity test method (e.g. immunoassay, enzyme assay), per patient encounter
**** Screening limited to one per patient, per encounter, per day, regardless of the number of procedures performed.

G0434 (DELETED 2016) – Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter
**** Screening limited to one per patient, per encounter, per day, regardless of the number of procedures performed.

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Billing and Coding Tips:
1. Append your modifier QW if your practice is “CLIA-waived”
2. Modifier 25 is not necessary if not required with an E/M encounter (check with the CCI/Edits for code conflicts)
3. Most of the time, you may need to have your rendering physician as the same “referring physician” (see and enter this on box 17 on HCFA 1500 02/12 Form)

*** No-brainer service billing tip =>> ALWAYS IDENTIFY MEDICAL NECESSITY FIRST AND FOREMOST!

Should you have any question, connect with me! I hope you found value in this blog post.

Related Reading:

Local Coverage Determination (LCD): Novitas Solutions Qualitative Drug Testing ( L34352 ) Jurisdiction Texas:
– > CLICK THE LINK http://www.novitas-solutions.com/LCDSearchResults/faces/spaces/search/page/lcd.jspx?Jurisdiction=JH&medicareType=Part+B&_afrWindowMode=0&lcdID=L34352&_afrLoop=2420171282400000&State=Texas&_adf.ctrl-state=bi5fjvniw_4
Clinical Laboratory Fee Schedule (CLFS)
Final Determinations -> CLICK THE LINK https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/Downloads/CY2015-CLFS-Codes-Final-Determinations.pdf

Blue Cross Blue Shield Arkansas (see page 16)
-> CLICK THE LINK http://www.arkansasbluecross.com/doclib/publications/providers%20news%20-%20march%202015.pdf

searched keywords: billing coding for urinary drug screening, immunoassay testing

billing coding for urinary drug screening, immunoassay testing

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Author: Pinky Maniri

Ms. Pinky, as she is fondly called - is a Reputable Professional Consultant and Expert in Practice Administration, Medical Billing, Coding, Health Information Technology, Insurance Credentialing and Compliance for Physician Offices. Well-educated with a Degree in Computer Systems Engineering and a background in Clinical Nursing and Small Business Management. Her professional mission is to make sure her clients/physicians maximize reimbursement while they remain compliant with the current rules, changes, guidelines and policies. Read More About Ms. Pinky here and See what Other's say about her Expertise Testimonials

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