G0431

Medicare is denying G0431 stating " The number of days or Units of service exceeds our acceptable maximum". We billed 12 units and Medicare says that we can only bill a max of 9 units. I can't find any information about the number of units allowed with G0431. Anybody have anything?

frequency

http://www.cms.gov/MLNMattersArticles/downloads/SE1001.pdf
this is best setteled by asking the Medicare payer for reference. G0431 – Drug screen, qualitative; single drug class method (e.g., immunoassay, enzyme assay), each drug class. New test code G0430 was created to limit the billing to one time per procedure and to remove the limitation of the method (chromatographic) when this method is not being used in the performance of the test. As a result, when performing a qualitative drug screening test for multiple drug classes that does not use chromatographic methods, new test code G0430 is the appropriate code to bill.

New test code G0431 is a direct replacement for CPT code 80101. However, CMS is delaying this replacement until April 1, 2010.

Similarly, from January 1, 2010 through March 31, 2010, when performing a qualitative drug screening test for a single class of drugs, regardless of the testing methodology, those clinical laboratories that do not require a CLIA certificate of waiver should bill new test code G0431. Those clinical laboratories that do require a CLIA certificate of waiver should continue to utilize CPT code 80101QW