G0431

Is it true that only one unit of G0431 is reimbursable per date of service?  Ty

re: G0431

Yes

re: G0431

http://www.trailblazerhealth.com/Tools/Notices.aspx?ID=14803

re: G0431

So if we perform qualitative drug screens on multiple drug classes on the same day we cannot be reimbursed for each drug class?  Is there no modifier that we can use to allow us to receive separate reimbursement? Ty

re: G0431

Per the code definition-G0431 is to be billed per patient encounter. Multiple units on the same date of service for a patient should be rare-and only acceptable when performed at a separate, medically necessary patient encounter. No modifier is appropriate, example, not -59 or -91.

re: G0431

Thank you very much.

re: G0431

You're right, I'm noticing many payers only reimburse 1 unit or won't pay it at all.

re: G0431

I would recommend checking the LCD with your Medicare Carrier for your area.

re: G0431

hcpcs description: "This code should be reported only once per patient encounter regardless of the number of drug classes tested." You can create the charges based on the number of tests performed, but then you need to lump it all on one line and translate the units to = 1 when the bill is generated.