Wiki D/L methamphetamine,urine

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Rhurst1

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We do methamphetamine testing in house, but if a D/L amphetamine is requested due to a positive methamphetamine we send this test to an outside lab if requested. To bill for this service for commercial payers we use 80374, however I am unsure as to the code to use for Medicare. Any guidance or experience in this area is greatly appreciated. Thanks
 
You cannot bill for performing a test that is being performed by a third party laboratory. They should be billing the test themselves, no? Perhaps I am not understanding the question.
 
hi, hopefully this link will work for you - I had to try and enter it several times, but it finally worked www.cms.gov/.../Downloads/CY2015-CLFS-Codes-Final-Determinations.pdf - it has the information you are looking for.
It is very common for our facility to obtain a sample from a patient and send it to the Mayo (a different lab) to be processed and we bill that charge from our facility. Unsure how your facility is set up, but you will want to research it.
Thanks,
Dana Chock, CPC, CCA, CANPC, CHONC, CPMA, CPB
Anesthesia, Pathology, & Laboratory Coder
 
Hi, Walker we fall below the 30% rule for Medicare and bill for testing that we send out because we are unable to perform a component of the test requested. We at that point become the referring lab and bill the services with modifier -90 and now with New guidance from CMS include the performing lab information on the claim form (previously wasn't required.) But, there are some major payers for example BCBS AL that require the performing lab to bill for the service.

Dana, I am not able to open the link you provided, but I am anxious to see it. what I am essentially looking for is the CMS crosswalk for code 80374. I see some major labs using the G6042 to represent this test to Medicare, but the reimbursement is low for the actual D/L isomer test being performed.

Any assistance, guidance, knowledge is appreciated. Thank You

Rene Hurst-Wall, CPC
 
Hi Rhurst1,

The correct code to bill for is G6042 with 2 units for Isomer Confirmation.
 
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Units for G6056 with Amerigroup

Does anyone know how many units does Amerigroup accepts for G6056?
 
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