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Still having 80101/ G0434 trouble

  1. #1
    Richmond, IN
    Default Still having 80101/ G0434 trouble
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    Why is Indiana Medicaid not accepting 80101 x 9 units (denied for units)? They have also denied G0434 x1 unit when I tried it (denied for non-covered procedure)... I have ask and I am not receiving any help regarding this from our Medicaid Rep. What should my next step be?
    Thank you!

  2. Thumbs up
    Hello Melissa,

    I had seen the code you were using 80101 and I am new to this but by reading in the CPT manual 2012 it states if multiple drugs can be detected using a single analysis (eg, one stationary phase with one mobile phase), use 80100 only once.

    also it states for qualitative analysis by multiplexed screening kit for multiple drugs or drug classes, use 80104

    don't know if this helps or not but good luck.


    Mary Robinson
    coding student studying to take the CPC-H exam May 12

  3. #3
    Lebanon, NH
    We are using 80104 for most insurance companies and the G0434 for Medicare. Hope that helps.

  4. Default
    With 80104 can you bill for multiple units if testing for more than 1 drug class. For example 80104x4?


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