please help

soprano

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Please help. This is third time posting this question. Our clinic recently started drug testing as part of our pain management program. We are using kits that test for 10 drug classes. It is my understanding that we should be billing 80104 x 1. Our drug testing liason is telling me to bill 80101 x 10. Does anyone know what the difference between these codes are?

I understand that G0434 is the code to bill Medicare for drug testing, however I am looking for advice on commercial carriers other than Medicare. Some of the commercial carriers do not accept the G code.

It has become a HUGE issue in our office and I just need some answers. Any thoughts would be appreciated.

Thank you.
 
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soprano

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Thank you for the link.

So... to be clear, it is my understanding that if we are testing for multiple drug classes with one urine sample, then we should bill either the G code or 80104
x 1. Not unless we are testing multiple urine samples with multiple dips are we to bill 80101 x multiple units, correct?

I hate to sound stupid but like I said there is a big difference of opinion in my office and my medical director is now forwarding the matter over to his attorney. I want to be clear before I argue my opinion on the subject.
 

AllisonDisessa

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Drug Testing

The G code id for medicare and medicare HMO's

80101 QW - the the qty is if you are using dip sticks and they are each a drug test

80104 QW is for a multiplex cup

I bill all the time to every carrier.
 

soprano

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The G code id for medicare and medicare HMO's

80101 QW - the the qty is if you are using dip sticks and they are each a drug test

80104 QW is for a multiplex cup

I bill all the time to every carrier.
Thank you , Allison. My problem is that my medical director asked our drug testing company and they told him to bill multiple units of 80101 for the multiplex CLIA waived cups. He even asked another drug testing company and they told him the same thing (80101).

So he has instructed me to bill multiple units of 80101 even though I advised him against it. I told him that I think it should be 80104, but he doesn't care what I think. Because two separate drug testing companies told him to bill with 80101 he believes them and NOT me.

I don't want to bill a code which I believe is wrong. Especially when the difference in reimbursement is huge. I'm afraid that we are going to end up with a recoupment from the private carriers, which I am trying to avoid.

I feel as though my employer has no faith in my ability as a coder. I'm frustrated and don't know what to do...
 
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