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Thread: 80101 LCD that support medical necessity

  1. #1

    Default 80101 LCD that support medical necessity

    Does anyone have the link from medicare/cms for the ICD-9 codes that are covered for the 80101

    This is for the monitoring of patient compliance in a drug treatment or for chronic pain patients.

    If anyone can help me that would be a great help I am just going around in circles on the cms website.

  2. #2
    Join Date
    Apr 2007
    Location
    Fayetteville, NC
    Posts
    300

    Default

    Per Payer Path this is what they have listed but when I click the LCD/NCD link I do not see any edits in place.
    For Medicare patients you need to use the code G0431
    3/22/2010 - Per Transmittal R653OTN, "Effective April 1, 2010, CPT code 80101 will no longer be covered by Medicare.

    V58.69 Encounter for other and unspecified procedures and...
    304.90 Drug dependence; unspecified drug dependence; unsp...
    V58.83 Encounter for other and unspecified procedures and...
    305.90 Nondependent abuse of drugs; other, mixed, or unsp...
    724.2 Lumbago
    304.01 Drug dependence; opioid type dependence; continuou...
    303.90 Other and unspecified alcohol dependence; unspecif...
    724.4 Thoracic or lumbosacral neuritis or radiculitis, u...
    304.00 Drug dependence; opioid type dependence; unspecifi...
    722.83 Postlaminectomy syndrome; lumbar region
    729.1 Myalgia and myositis, unspecified
    724.5 Backache, unspecified
    722.52 Degeneration of thoracic or lumbar intervertebral ...
    304.80 Drug dependence; combinations of drug dependence e...
    V72.6 Special investigations and examinations; laborator...
    305.91 Nondependent abuse of drugs; other, mixed, or unsp...
    250.00 Diabetes mellitus without mention of complication,...
    305.00 Nondependent abuse of drugs; alcohol abuse; unspec...
    304.20 Drug dependence; cocaine dependence; unspecified
    723.1 Cervicalgia
    295.70 Schizoaffective disorder; unspecified
    338.29 Other chronic pain
    V82.9 Special screening for other conditions; unspecifie...
    715.09 Osteoarthrosis, generalized; multiple sites
    A. McCormick, CPC, CGSC
    Walters Surgical Associates

  3. #3

    Default Go434

    Does anyone know if the G0431 has now changed to G0434 (CLIA waived test)?

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