2017 Drug Testing Codes

dwaldman

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Clinical Laboratory Fee Schedule (CLFS) Annual Laboratory Public Meeting Calendar Year 2017 Updates July 18, 2016
New Test Codes
Drug Assay

803X1X Drug test(s), presumptive, any number of drug classes, qualitative, any number of devices or procedures, (eg, immunoassay) capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service

803X2X Drug test(s), presumptive, any number of drug classes, qualitative, any number of devices or procedures, (eg, immunoassay) read by instrument assisted direct optical observation (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service

803X3X Drug test(s), presumptive, any number of drug classes, qualitative, any number of devices or procedures by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed, per date of service

https://www.cms.gov/Medicare/Medica...hed/Downloads/CY2017-Public-Meeting-Codes.pdf
 

CodingKing

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So it sounds like not much is changing other than the presumptive will move from G code to 8XXXX series but descriptions are the same?
 

dwaldman

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CodingKing For the first two presumptive codes (803X1X, 803X2X) that crosswalk to (G0477, G0478) the code descriptors seem to have been updated to include the word "qualitative."

For new CPT 803X3X, they have also added the word "qualitative" but they have also expanded the description of the techniques with the new code:

G0479
utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry),

803X3X
utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF)
___________________________


G0477
Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service

803X1X Drug test(s), presumptive, any number of drug classes, qualitative, any number of devices or procedures, (eg, immunoassay) capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service
_________________________________

G0478
Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service


803X2X Drug test(s), presumptive, any number of drug classes, qualitative, any number of devices or procedures, (eg, immunoassay) read by instrument assisted direct optical observation (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service
________________________________________

G0479
Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when performed, per date of service


803X3X Drug test(s), presumptive, any number of drug classes, qualitative, any number of devices or procedures by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed, per date of service
 

dwaldman

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CPT and descriptor now available for 2017

80305 Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service

80306 read by instrument assisted direct optical observation (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service

80307
Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (eg, utilizing immunoassay [eg, EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (eg, GC, HPLC), and mass spectrometry either with or without chromatography, (eg, DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed, per date of service
 

CodingKing

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This is what I sent to my team this morning. We actually only learned today that some of the G codes are terming

Here is the link that discusses the upcoming changes

https://www.cms.gov/Medicare/Medica...ds/CY2017-CLFS-Codes-Final-Determinations.pdf


From what I’ve read so far

Definitive drug screening (codes G0480-G0483) are going to be revalued and the description is going to be clarified since they are being misused. CMS is also going to create a new code (G0659) for laboratories that are running a less sophisticated version of the test.

Presumptive drug screen (codes G0477-G0479) are going to be mapped to the new drug screen codes 80305-80307 and then the G0477-G0479 will be termed as codes

The rest of the document is about unrelated lab codes.
 

CodingKing

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MCPFS RVU file last time I checked just listed the new 8xxxx codes with an SI of A (Unlike the SI of I for the definitive) but I didn't see any RVU's assigned yet so I'm not even sure what the rate is supposed to be.
 
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