Wiki Drug screen coding

[anuja.devasthali]

Hi,

For Medicare I am aware that CPT G0434 needs to be used if the drug screen done by multi-class clia waived test kit. ( 11 panel )

For other payers till now I was using CPT 80104. Is this correct ?

This CPT 80104 is yet not added in CLIA waived test list & hence not recognised by many payers resulting in denial of CPT 80104, specifically medicaid plans.

Kindly advise.

 

[btadlock1]

Hi,

For Medicare I am aware that CPT G0434 needs to be used if the drug screen done by multi-class clia waived test kit. ( 11 panel )

For other payers till now I was using CPT 80104. Is this correct ?

This CPT 80104 is yet not added in CLIA waived test list & hence not recognised by many payers resulting in denial of CPT 80104, specifically medicaid plans.

Kindly advise.

80104 is correct - Medicaid can be weird about what they want, though - they tend to play by their own rules. You should check with your Medicaid provider for guidance. I guarantee that they have information on it - probably online.