Wiki Urine Toxicology Confirmatory Billing 2016 Questions

[alex.strahan@healthcarers.com]

If this is the test panel for confirmations for commercial insurances, are these the correct codes? If not, can someone tell me why?

Codeine 80361
Hydrocodone 80361
Hydromorphone 80361
Morphine 80361
Oxycodone 80365
Oxymorphone 80361
Noroxycodone 80361
Buprenorphine 80301
Norbuprenorphine 80301
Fentanyl 80354
Norfentanyl 80354
Meperidine 80362
Normeperidine 80362
Methadone 80358
EDDP 80358
Naloxone
Naltrexone
Propoxyphene 80367
Norpropoxyphene 80367
Sufentanil 80354
Tapentadol 80372
Tramadol 80373
Alprazolam 80346
Hydroxyalprazolam 80346
Carisoprodol 80369
Meprobamate 80369
Clonazepam 80346
Diazepam 80346
Nordiazepam 80346
Temazepam 80346
Oxazepam 80346
Flunitrazepam 80301
Flurazepam 80346
Lorazepam 80346
Midazolam 80346
Amphetamine 80324
Pregabalin 80366
6-MAM 80356, 80361
Benzoylecgonine 80353
MDA 80359
MDEA 80324, 80359
MDMA 80359
Methamphetamine 80324
PCP 80301
THC 80349

 

[CodingKing]

I sure hope you are not billing all of those codes for every patient. You shouldn't be billing for quantitative analysis on metabolites unless there was some sort of positive indication on the Qualitative sample. You can still use CPTs for commercial unless they are adopting Medicare's updated G codes.

 

[alex.strahan@healthcarers.com]

No they arent billed for every patient. This is the master list of panels. It's just confusing because there's a 2015 set of G codes (around 8-10) for this list and then theres a 2016 single G code that would be applicable for this list.

 

[CodingKing]

2016 G code changes

The following are being deleted G0431, G0434, G6030-G6058

presumptive testing (screening) new codes G0477-G0479

definitive testing (diagnostic) new codes G0480-G0483

Definitive will be a single code reported based on number of drug classes including metabolite(s)

G0480 1-7
G0481 8-14
G0482 14-21
G0483 22+

 

[alex.strahan@healthcarers.com]

Thanks CodingKing, I appreciate it. Those are the codes I had written down to use for Medicare. I think with all the changes the only thing that will work outside of Medicare is trial and error!

 

[barbcal33]

Barbie

I have been calling on VOB's and a few of the insurance companies are not recognizing the G0478 drug screening code , yet they are saying the G0431 is still a billable code. It was my understanding the G0431 was a deleted code as of 2016. Anyone else running into this problem ?

 

[natashabarnes]

I am running into the same problem with the G0477, everyone is saying that they are not recognizing it but yes the G0431 did end in 2015