Shade Posted Mon 20th of October, 2014 10:20:06 AM
IF A URINE SAMPLE WAS COLLECTED ON SITE FOR ONWARD TO THE LAB FOR DRUG SCREENING. CAN I STILL USE 81001 CODE OR IS THERE ANOTHER BEST CODE TO BE USED. SINCE LAB DID THE SCREENING FOR THE DRUG. PLEASE HELP.
SuperCoder Answered Tue 21st of October, 2014 02:00:07 AM
You may use either of the following codes based on the type of drug testing and payer specific guidelines. These services may be performed within the provider office and/or sent to a reference lab -
80100, 80101, 80102, 80104, G0431 and G0434.
Medicare do not cover codes 80100, 80101 and 80104. To bill Medicare, you may use only two codes G0431 and G0434. Most commercial payer have specific guidelines to report urine drug testing and may or may not accept any of the above codes. Please check with your payer.
80100 represents 'Drug screen, qualitative; multiple drug classes chromatographic method, each procedure'.
80101 represents 'Drug screen, qualitative; single drug class method (eg, immunoassay, enzyme assay), each drug class.'
80104 represents 'Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure'.
G0431 represents 'Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter'.
G0434 represents 'Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter'.
Shade Posted Tue 21st of October, 2014 08:44:21 AM
i understand that my question is if the screening was not done on site what is the best code for the collection of the specimen for screening.
SuperCoder Answered Wed 22nd of October, 2014 01:10:10 AM
CPT code 99000, “Handling and/or conveyance of specimen for transfer from the physician's office to a laboratory,” is intended to be reported when the practice incurs costs to handle and/or transport a specimen to a lab.
Under CPT rules, collection of a specimen unless there is a specific CPT code that describes the collection (such as taking a blood sample) are included to the E/M service. That said, most payers will deny a handling fee which can only be billed once no matter how many samples are collected. CPT has always indicated that the code 99000 is only appropriate to report when the costs incurred by the practice in handling the specimen are above normal practice expenses (ie, overhead costs). If you can show significant additional work in preparing the specimen to send to the lab, you may be able to make a case for payment.