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Drug Testing for Oral Fluid instead of Urine

Messages
2
Location
Melbourne
Best answers
0
I'm with an SIU and we are consistently seeing labs that are billing for Oral Fluid Drug Testing using the G0480-G0483 series codes. Does anyone have a better code recommended for billing using Oral Fluid drug testing in both Pain Management and Substance Abuse?

We usually follow Medicare Guidelines and our Policy is based on the LCD for UDT's and we are having difficulty finding any guidance surrounding Oral Fluids as LCD L36393 only mentions Oral Fluid in a very general sense, everything is aimed directly at urine. There are no specific CPT or HCPCs codes mentioned as appropriate to be used for Oral Fluid testing or guidance.

We did locate 0011U-Prescription drug monitoring, evaluation of drugs present by LC-MS/MS, using oral fluid, reported as a comparison to an estimated steady-state range, per date of service including all drug compounds and metabolites. This is listed as a PLA code but I'm not entirely sure what would be required to verify that the lab performing this service is properly set up to perform this service.

Any help would be greatly appreciated.
 

tammyboyer

Networker
Messages
32
Best answers
0
oral drug testing

Tina did you ever find out how we are to code for oral definitive drug testing? i am at a loss.
 

Cavalier40

Guru
Messages
137
Location
Stuart, FL Sailfish Chapter
Best answers
0
This is a difficult one because the G0480-G0483 code descriptions do not specify urine, but the LCD is only referring to Urine Drug Screening. I would say possibly that the individual CPT codes 80320-80377 would work in a definitive setting, but following Medicare guidelines would redirect back to the G codes. I would just ask the question why they are using oral fluid over urine. I wish I had a better answer.
 
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