2016 G-Codes, Definitive Drug Testing, G0480, G0481, G0482, & G0483 OPINIONS PLEASE!

Sue2424

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New 2016 G Codes for Drug Testing, G0480, G0481, G0482, & G0483 OPINIONS PLEASE!

When using codes G0480, G0481, G0482, & G0483 it's my understanding that you do not and can not bill these codes with more than one unit.
I've read the description for all codes and that's the only way I understand it. Please tell me if I am wrong!

UHC has just started denying the old codes and I am sending corrected claims on them, but my supervisor is telling me to bill for 4 units on G0480 because that's the number of drugs tested for, I explained my thoughts on it but she is not seeing it that way.

Please tell me your thought!! And if I am wrong then why 4 different codes for different amounts of drug classes???

Please give me opinions, I would greatly appreciate them!!!
 
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CodingKing

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You are correct. These cannot be billed with more than 1 unit even if you did the payers system will be smart enough to deny them. Id say print out the page in the HCPCS manual and highlight the

"per day, 1-7 drug class(es), including metabolite(s) if performed"
"per day, 8-14 drug class(es), including metabolite(s) if performed"
"per day, 15-21 drug class(es), including metabolite(s) if performed"
"per day, 22+ drug class(es), including metabolite(s) if performed"

Id also refer the boss to the MUE tables showing the maximum of 1 unit.
 

Sue2424

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Location
Benton, IL
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You are correct. These cannot be billed with more than 1 unit even if you did the payers system will be smart enough to deny them. Id say print out the page in the HCPCS manual and highlight the

"per day, 1-7 drug class(es), including metabolite(s) if performed"
"per day, 8-14 drug class(es), including metabolite(s) if performed"
"per day, 15-21 drug class(es), including metabolite(s) if performed"
"per day, 22+ drug class(es), including metabolite(s) if performed"

Id also refer the boss to the MUE tables showing the maximum of 1 unit.



Thank You!!! I felt like banging my head off my desk!!
I'm new to coding labs but I can read, and I don't know where she is coming from, so thank you! :)
 
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