biller007
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I need some help in regards to Urine Drug Screens in the office. Medicare changed the 80101 to a G0434 in 2011, stating billible 1 per encounter. BCBS states bill per drug class, which there are 6-10 drug classes, which would tell you to quantify the 80101. These physicians are paying less than $5.00 per UDS, Medicare is paying $12.54 for 1 per encounter. (which makes sense to me), but if we bill BCBS for a quantity of 10 (1 for each drug class) they will pay us $121.20. I am trying to tell BCBS they are OVERPAYING for this service now as to avoid doing million dollar refunds in the future. No one can help me, the code in the CPT manual states per drug class as well. The EXACT same UDS is being used for Medicare pt's as BCBS pt's. Isnt there an issue here??? I would appreciate any help with this, I have been all over the internet and the AAPC website, it seems that I am not the only one confused here. Please advise as how I should proceed. I somehow cannot wrap myself around billing one insurance 25.00 and the other 200.00 for the same thing. Thanks in advance for any help you may offer. I have email coorespondance from BCBS as well. Amber Logan, CPC, CMC
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