Wiki 80307 vs g0481

hbarney1

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Hello,

So I have been getting a couple of denials from Medicare on the procedure code 80307. I looked up online and saying that if it is Medicare I can change it to a HCPCS code (G0481). Some of those denials when I change the code the diagnosis is covered. I looked up on this some, but is this 100% every time I get one or on some cases? I am looking way into it and questioning myself on this. Thank you for any help.
 
By crosswalking they are referring to rate setting not coding assignment. 80305-80307 is for presumptive drug testing, G0480-G0483 is for definitive drug testing. I'd check the LCD that may give you some advice as to covered diagnosis codes and frequency limits. You cant substitute one of the other. it depends on type of testing done.
 
So my question is when I work on a Medicare claim and the code is 80307 and when I look at the LCD and find a code that is in the account that is covered for G0481, am I able to change the CPT to a HCPCs code? I am not sure if I can do it every time I have an error for 80307 or if it depends. I hope that makes sense.
 
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