How to Bill and Code for Urine Drug Screen to Medicare
Jan07

How to Bill and Code for Urine Drug Screen to Medicare

*** 2017 NEW CPT CODES FOR URINE DRUG SCREENING – READ AND CLICK HERE! Here’s an article on How to Bill and Code for Urine Drug Screen to Medicare The Necessity of Drug Screening A pain doctor may perform drug screening test on his patients making sure his patients are compliant with their prescribed pain medication especially when they are on narcotic pain medications. But how to bill and code for urine drug screen to Medicare is different when billing to the Commercial Insurance payers. Since 2011, your drug screening codes from your CPT Coding Book is non billable and cannot be reported to Medicare when reporting for drug screenings tests. The Following Codes are no longer accepted by Medicare since January 1, 2011 80100 (has not been priced under Medicare effective January 1, 2011) 80101 (has not been priced under Medicare effective July 1, 2010) 80104 (has not been priced under Medicare effective January 1, 2011) So when you are billing Medicare for Drug Screening, you have 2 HCPCS codes to choose from.  G0431  (Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter) will be used to report more complex testing methods, such as multi-channel chemistry analyzers, where a more complex instrumented device is required to perform some or all of the screening tests for the patient. Note that the descriptor has been revised for CY 2011. May only be reported when tests are performed using instrumented systems (i.e., durable systems capable of withstanding repeated use).  Do not report with Modifier QW (CLIA-waived)   Report only one unit per patient per encounter, regardless of the number of drug classes being tested (or detected)  G0434 (Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter)  Report only one unit per patient per encounter, regardless of the number of drug classes being tested (or detected)  (Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter)  Append Modifier QW (CLIA-Waived)  This will be used to report very simple testing methods, such as dipsticks, cups, cassettes, and cards, that are interpreted visually, with the assistance of a scanner, or are read utilizing a moderately complex reader device outside the instrumented laboratory setting (i.e., non-instrumented devices). Keypoints to always remember on how to bill and code drug screen to Medicare 1. Render service based on medical necessity 2. G0431 or G0434 can only be reported one unit of service per patient encounter, regardless of the number of drug classes being tested (or detected) 3....

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