I have a few answers and more questions.
I work with several pain management practices who drug screen/test. I just attended a dinner meeting/sales pitch with a rep from a "table top drug screen reader" company.
His pitch is this:
With the new G0431 code, Medicare will no longer pay for the single class test without performing the screen on a table top reader. The table top reader costs $80,000 to buy or $2,000 to lease. With our volume of 40 - 60 screens per week and reimbursement of $20 per class, the numbers still work.
Here are my questions:
1. The verbage is the same for both codes, what's the difference?
G0431 - DRUG SCREEN, QUALITATIVE; SINGLE DRUG CLASS METHOD (E.G., IMMUNOASSAY, ENZYME ASSAY), EACH DRUG CLASS
80101 - Drug screen, qualitative; single drug class method (e.g., immunoassay, enzyme assay), each drug class
2. When does new code take effect? NGS Medicare has an LCD (28145) with BOTH codes on it. It does not indicate when G0431 becomes effective for Part B. (It states that Part A carriers will be effective April 1st)
3. Does the new code require a table top reader and not just urine dip strips?
4. Finally, NGS Medicare does not list either code G0430 or G0431 on their fee schedule.
Brock Berta, CPC
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