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G0431 versus G0434

Pam Posted Mon 09th of March, 2015 11:57:33 AM

We are a hospital performing qualitative drug testing on an analyzer. Should we be billing G0431 or G0434?

SuperCoder Answered Tue 10th of March, 2015 04:38:33 AM


G0431 is used to report more complex testing methods, such as multichannel chemistry analyzers,where a more complex instrumented device is required to perform some or all of the screening tests for the patient. G0431 may only be reported if the drug screen test(s) is classified as CLIA high complexity test(s) with the following restrictions:

G0431 may only be reported when tests are performed using instrumented systems (i.e.durable systems capable of withstanding repeated use).

CLIA waived tests and comparable non-waived tests may not be reported under test code G0431; they must be reported under test code G0434.

CLIA moderate complexity tests should be reported under test code G0434.


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