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80101 help

  1. #1
    Default 80101 help
    Medical Coding Books
    We have a patient from a rehab that we do perodic drug testing on. We used 80101 with V82.9. Is this the proper diagnosis. The lab is billing for an alcohol test with 80101 also and the insurance company is stating claim already billed. I want to get an experienced opinion on the 80101 with V82.9 to make sure this is correct prior to appealing. Any help is appreciated.
    Thank you,

  2. Default
    If you're performing the POC drug screens, your cups/strips don't include alcohol???
    If your lab knows your performing the POC and billing 80101, then the lab should not be also using 80101...
    The lab should only be using the specific CPT for the confirmation of a positive alcohol POC :82055

    The carriers have no way of distinguishing what screenings are being performed since 80101 is not drug class specific. So who ever bills first, gets paid first.
    Unfortunately, by both you and the lab using the same code, you are opening yourself up for an audt for double billing and lost revenue for services you are performing. A call to the lab in question should be made to determine why they are billing 80101.

    As for the dx, using an unspecified dx might not be the way to go.
    You might want to refer to the few LCDs that are out there for qualitative screenings.
    Even though you are billing these to comercial carriers, the LCD can still be a handy reference guide for what is considered MN for these services.

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