Forum - Questions & Answers

Jul 23rd, 2014 - Suewentworth

Urine drug screening for substance abuse and chronic pain

There is so much confusion on what codes to use for billing for urine screenings. Some say use the 80100 code with the numbers of tests, others say use the G0431 code. How are we to know which to use, if you call the carriers they say they can't tell us what to bill. Any suggestions GREATLY appreciated.

Jul 23rd, 2014 - Jackfraust 69 

re: Urine drug screening for substance abuse and chronic pain

It depends on how the screen was done- there is a web address under G0431-
http://cms.hhs.gov/mlnmattersarticles/downloads/se1001.pdf
that reveals the following info- (partial copy) "It came to CMS’ attention that some companies were using questionable billing practices concerning CPT® Code 80100 and CPT® Code 80101. In addition, CPT® Code 80100 describes only chromatographic testing for the presence of drugs, which left certain laboratories unable to bill accurately when this type of testing was performed, but the chromatographic method was not utilized. Therefore, CMS created two new G codes to operate in place of and alongside existing CPT® Code 80100 and existing CPT® Code 80101. Following are the current definitions of all test codes addressed in this issue: • CPT® Code 80100 – Drug screen, qualitative; multiple drug classes chromatographic method, each procedure • G0430 [the current code used is G0431] – Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure..."



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