".......Drug classes may contain one or more codes based on the number of analytes."
AMA CPT Changes 2015
The Definitive Drug Classes Listing provides the drug classes, their associated
CPT codes, and the drugs included in each class. Each category of a drug class, including metabolite(s) if performed (except stereoisomers), is reported once per date of service. Metabolites not listed in the table may be reported using the code for the parent drug. Drug class metabolite(s) is not reported separately unless the metabolite(s) is listed as a separate category in Definitive Drug Classes Listing (eg, heroin metabolite).
Drug classes may contain one or more codes based on the number of analytes. For example, an analysis in which five or more amphetamines and/or amphetamine metabolites would be reported with 80326. The code is based on the number of reported analytes and not the capacity of the analysis.
Definitive drug procedures that are not specified in 80320-80373 should be reported using the unlisted definitive procedure codes 80375, 80376, 80377, unless the specific analyte is listed in the Therapeutic Drug Assays (80150-80203) or Chemistry (82009-84830) sections.
Clinical Example (80346 )
A 58-year-old female with severe fibromyalgia pain is prescribed 20 mg controlled release oxycodone and 0.5 mg clonazepam twice per day and tests positive for opiates using a qualitative, presumptive direct observation dipstick device. The qualitative dipstick device is negative for benzodiazepines. The patient denies any deviation from dosing instructions for both oxycodone and clonazepam. Before the prescription refill is issued, a urine specimen is sent to the laboratory to confirm the clonazepam metabolite is present or if presumptive results are false negative.
Description of Procedure (80346 )
A quantitative, definitive GC/MS analysis for six common benzodiazepines is performed. Any of the instrumental techniques that are defined as definitive may be use. These are high-complexity tests, such as LC-MS/MS or GC/MS. Exact methodology varies by testing facility, but all are instrumental techniques with the ability to specifically identify individual drugs and metabolites, if tested, within a class and rule out interfering drugs and other substances. See descriptions of definitive tests in the Definitive Drug Testing introductory guidelines.
Results indicate the presence of 7-aminoclonazepam, consistent with the use of clonazepam, a benzodiazepine that is not detected using the dipstick device. From these results, the clinician refills the prescription.
Clinical ExampleClinical Example (80347 )
A 58-year-old female with severe fibromyalgia pain is prescribed 20 mg controlled release oxycodone and 0.5 mg clonazepam twice per day and tests positive for opiates using a qualitative, presumptive direct observation dipstick device. The qualitative dipstick device is negative for benzodiazepines. The patient denies any deviation from dosing instructions for both oxycodone and clonazepam. Before the prescription refill is issued, a urine specimen is sent to the laboratory to confirm the clonazepam metabolite is present or if presumptive results are false negative.
Description of Procedure (80347 )
A quantitative, definitive GC/MS analysis for six common benzodiazepines is performed. Any of the instrumental techniques that are defined as definitive may be use. These are high-complexity tests, such as LC-MS/MS or GC/MS. Exact methodology varies by testing facility, but all are instrumental techniques with the ability to specifically identify individual drugs and metabolites, if tested, within a class and rule out interfering drugs and other substances. See descriptions of definitive tests in the Definitive Drug Testing introductory guidelines.
Results indicate the presence of 7-aminoclonazepam, consistent with the use of clonazepam, a benzodiazepine that is not detected using the dipstick device. From these results, the clinician refills the prescription.
See the Definitive Drug Classes Listing on pages [232-234] for a listing of the more common analytes within each drug class
80346 Benzodiazepines; 1-12
80347 13 or more