Outpatient Facility Coding Alert

Published on Wed Nov 26, 2014 PDF

Question: If a urine sample was collected on site for onward to the lab for drug screening, can I still use 81001, or there is any other code?

Texas Subscriber

Answer: Currently, you may use the following codes based on the type of drug testing and payer specific guidelines, but keep in mind that coding for drug testing has been overhauled for 2015. These services may be performed within the provider office and/or sent to a reference lab:

• 80100 (Drug screen, qualitative; multiple drug classes chromatographic method, each procedure)
  
• 80101 (Drug screen, qualitative; single drug class method (eg, immunoassay, enzyme assay), each drug class)
  
• 80104 (Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure)
  
• G0431 (Drug screen, qualitative; multiple drug classes by high complexity test method [e.g., immunoassay, enzyme assay] per patient encounter)
  
• G0434 (Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter).
  

Caveat: Medicare does not cover codes 80100, 80101, and 80104. To bill Medicare, you may use only G0431 and G0434. Most commercial payers also have specific guidelines to report urine drug testing and may or may not accept any of the above codes. Check with the payer to verify coding before submitting the claim.