We are billing for in-office urine drug screening for our pain management patients. It is a cup with 10-12 drugs tested with results displayed on the cup. We are coding the screening with CPT 80305 and diagnosis code of Z13.89. The service is being denied as the diagnosis is inconsistent with the procedure. Can someone that is familiar with this service and advise what diagnosis code we should be using for the in-office urine drug screen. Also, are we are using the correct CPT code as well. Thank you for any feedback we can receive.
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Urine Drug Screen Coding
- Thread starter mamoore56
- Start date
TThivierge
True Blue
Hello Mamoore 56,
Ahh CPT 80305 is out of sequence per CPT manual . It tells use another lab test. Provider needs to give another urine lab test to useor more direction. I have been told to use for urine test CPT 81003 81001 80069 82565 but with orders. I have use N28.89 defines organ releases urine to be tested. If patient suffering with chronic DM dx E11, or CKD N18 or HTN I10 or UTI dx N39 use those related to documentation. you state pain management is caused by what illness such as: Back pain M54 or M47, Cancer C60 ,or Arthritis ? I d take this CPT lab 80305 & ask to get a dx that patient has or provider is searching for or monitoring a illness.
I hope helped you
Lady T
Ahh CPT 80305 is out of sequence per CPT manual . It tells use another lab test. Provider needs to give another urine lab test to useor more direction. I have been told to use for urine test CPT 81003 81001 80069 82565 but with orders. I have use N28.89 defines organ releases urine to be tested. If patient suffering with chronic DM dx E11, or CKD N18 or HTN I10 or UTI dx N39 use those related to documentation. you state pain management is caused by what illness such as: Back pain M54 or M47, Cancer C60 ,or Arthritis ? I d take this CPT lab 80305 & ask to get a dx that patient has or provider is searching for or monitoring a illness.
I hope helped you
Lady T
jkyles
True Blue
- Messages
- 937
- Best answers
- 1
The lab code is right but that diagnosis code is incredibly vague and the clarifying term for it is "Encounter for screening for genitourinary disorders". That doesn't make sense for a UDT.
The diagnosis code you use must reflect exactly why the provider ordered the test. Ask them what they're screening for and select a diagnosis code based on that information. I also recommend reading your payer/carrier policies for urine drug tests because they're fairly strict.
Last edited: