Results 1 to 6 of 6

Chronic Pain Clinic- Brand New- PLEASE HELP

  1. Question Chronic Pain Clinic- Brand New- PLEASE HELP
    Medical Coding Books
    The company that I work for is an anesthesia billing company. We are taking on a new client that will be a chronic pain provider. He will have his own office that he provides services out of. When a new patient comes into the office he will be performing a drug test & the screening right there in the office. Also when a patient that recieves pain management routinly the provider will be repeating the screening each time.

    This provider does not have a CLIA certificate, but rather a CLIA waiver. We need to know what codes would be used for the collection of the specimen, what code would be used for the screening, and what code for the repeat test and screening when the patient is not concidered a new patient.

    Any help or guidence is VERY MUCH APPRECIATED!!!!! Thank you in advance!! :-)

  2. Default
    You can use 80101 with a QW modifier for the drug screen if they're doing a urine dip. You would bill this for each class of drug tested. This code is only valid for MC until 4/1/10 at which time you have to start using the HCPCS codes G0430 and G0431. My understanding is that MC is supposed to release new guidance on April 1st regarding billing the G codes.

  3. #3
    St. Joseph County, Indiana
    There is quite a lot of controversy and confusion regardind the new way to bill for drug screens. Go to the pathology/laboratory section of the coding forum. I have a few long discussions related to 80101 and G0431 from February and March. It's not a simple answer.

  4. Default
    Here is the link to the CMS manual update effective 4/1/10

  5. Default
    Thank for all of your help!!!! We really appreciate it!!!

  6. #6

    G0430 under this code in the above link Medicare lists all drug screens that test for multiple drug classes

    G0431 under this code they list tests like the Quickscreen One Step Opiate Screening test. This test and other tests listed under G0431 are only testing for one drug class.

Similar Threads

  1. AHA Coding Clinic on Chronic Conditions, in HCC Context
    By tbuxton in forum Medical Coding General Discussion
    Replies: 5
    Last Post: 12-29-2014, 08:30 PM
  2. pain clinic
    By jerseygirl20 in forum Outpatient Facilities
    Replies: 0
    Last Post: 03-10-2014, 12:36 PM
  3. Chronic Pain vs. Chronic Pain Syndrome
    By Jessica Ann in forum Diagnosis Coding
    Replies: 1
    Last Post: 01-15-2014, 08:51 PM
  4. Chronic pain
    By Thilaga in forum Diagnosis Coding
    Replies: 2
    Last Post: 06-14-2013, 12:39 PM
  5. Chronic pain dx
    By soprano in forum Behavioral Health
    Replies: 0
    Last Post: 05-30-2012, 11:39 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.