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Old 11-18-2011, 10:49 AM
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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.
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Old 11-22-2011, 01:03 PM
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Grintwig Grintwig is offline
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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
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Old 03-22-2012, 09:34 AM
cvzzz cvzzz is offline
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Default Go434

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