I'm getting very confused with all the codes and meanings.
I have been using 80100 for our CLIA WAIVED One Step Multi-Drug Multi-Line Screen Test Device. Tests for amphetamine, cocaine, marijuana, methamphetamine, opiates, and phencyclidine. It is a chromatographic immunoassay for the qualitative detection of multiple drugs and drug metabolites in urine. I have to use a -ZS modifier for Medi-Cal.
I was comfortable thinking that I'd use the 80101 for suboxone screenings until I looked in the Medi-Cal manual to see if I needed a modifier. There is a section on pathology: drug testing that G0431, G0434, 80102 and 83925 are acceptable codes to bill to them.
Further in the manual it says Code 80102 is used to bill the testing for the presence (qualitative testing) of any drug, drug class or substance of abuse. This code is not restricted to any specific laboratory method or technology. Additional different testing is allowed, when necessary, to confirm a positive initial qualitative screening test.
Then further than that it says Outpatient heroin (narcotic) detoxification programs may not bill for CPT-4 code 80102 since payment for screening tests is included in the Medi-Cal-per-visit allowance for these programs.
Now my question is, is the correct code for the screening of Suboxone 80101 or 80102. I know that I keep seeing that 80102 is a confirmation of a previous positive result, but COULD it be interpreted to mean that 80102 is confirming the presence of a drug that should be there in the first place? I know, I'm probably reading into it.
Just trying to get the proper answer. Thanks!!
Any feedback would be great even if it's confusing
- Medical Coding
- Medical Billing
- Practice Management
- Exam Preparation
- Other Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Software / Digital
- Code Lookup (AAPC Coder)
- Virtual Coding Experience (Practicode)
- E/M Analyzer
- CPT RVU Calculator
- Health Plan Search (Provider Policies)
- Log In / Join