As mentioned in the National Correct Coding Initiative Policy Manual, Chapter 10, Section E, beginning January 1, 2016, definitive drug testing may be reported with HCPCS codes G0480-G0483. These codes differ based on the number of drug classes including metabolites tested. Only one code from this code range may be reported per date of service.
Full Answer
What are the drug testing codes for 2016 in CMS?
CMS Drug Testing Codes for 2016. G0478 Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures, (eg immunoassay) read by instrument-assisted direct optical observation (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service. G0479 Drug tests(s), presumptive,...
What is a qualitative drug screen?
A qualitative/presumptive drug screen is used to detect the presence of a drug in the body. A blood, urine, or oral fluid sample may be used. However, urine is the best specimen for broad screening, as blood is relatively insensitive for many common drugs, including psychotropic agents, opioids, and stimulants.
How is a definitive drug testing code billed?
One definitive drug testing code may be billed once per patient per day as indicated by the code description and should only be billed at one unit regardless of the provider. The documentation should support the medical necessity of the drug testing ordered and should support the clinical indicators that led to ordering the test.
What happened to the drug testing codes g6030-g6058?
For 2016, CMS deleted definitive drug testing codes G6030-G6058 and replaced them with a handful of new codes:
What is the difference between 80305 and 80307?
CPT 80305 is drug screening by dipsticks, cups, cards or cartridges read visually. CPT 80306 is drug screening by dipsticks, cups, cards or cartridges read on an instrument reader. CPT 80307 is drug screening on a chemistry analyzer.
What does CPT code 80307 test for?
presumptive drug testsMost presumptive drug tests at Quest Diagnostics will fit the CPT code 80307. An example of a presumptive drug test is the enzyme multiplied immunoassay, in which the assay reagents include an antibody to the drug and an enzyme-labeled drug molecule of the same drug that is being tested.
What is code G0480?
• G0480: Drug test(s), definitive, utilizing (1) drug identification methods able to identify. individual drugs and distinguish between structural isomers (but not necessarily. stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS.
What is code G0482?
HCPCS code G0482 for Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding ...
Does Medicare pay for CPT code 80305?
The AMA CPT code for drug testing using our 12 panel drug test cups, which is the code used for Medicare B and most other insurers, is 80305.
What is the CPT code for drug screening?
CPT Code 80301 Description of CPT 80301: Drug screen, any number of drug classes from Drug Class List A; single drug class method, by instrumented test systems (eg, discrete multichannel chemistry analyzers utilizing immunoassay or enzyme assay), per date of service.
What is code 87635?
87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique.
What is G0463 used for?
HCPCS Code G0463 is used for all FACILITY evaluation and management visits, regardless of the intensity of service provided.
What is Prsmv Chem Anlyzr?
DRUG TEST PRSMV CHEM ANLYZR CPT 80307 is appropriate when test is performed by instrumented. chemistry analyzers (e.g. Immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, CHPC, GC mass spectrometry). Test includes validity testing when performed and may be performed only once per date of service.
What code is G0483?
HCPCS code G0483 for Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding ...
Can G0480 and 80307 be billed together?
b. Drug confirmation testing is considered included in CPT codes 80305 – 80307 and HCPCS codes G0480 – G0483, G0659, and is not eligible for separate reimbursement.
What is the code 99213?
CPT® code 99213: Established patient office visit, 20-29 minutes | American Medical Association.
General Information
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
Article Guidance
The billing and coding information in this article is dependent on the coverage indications, limitations and/or medical necessity described in the related LCD L34645 Drug Testing.
ICD-10-CM Codes that Support Medical Necessity
For monitoring of patient compliance in a drug treatment program, use diagnosis code Z03.89 as the primary diagnosis and the specific drug dependence diagnosis as the secondary diagnosis.
Bill Type Codes
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.
Revenue Codes
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.
Document Information
CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
CMS National Coverage Policy
Title XVIII of the Social Security Act section 1862 (a) (1) (A).
Coverage Guidance
A qualitative/presumptive drug screen is used to detect the presence of a drug in the body. A blood or urine sample may be used.