Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95

Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

UTD and Confirmation Billing

Debra Posted Mon 30th of January, 2017 14:35:08 PM
Pain management clinic we bill a urine drug test screen by the date the specimen was received CPT 80307. The specimen is reviewed and then a confirmation test is done G0483. With this we got denials when we tried to bill these on the same date of service. My lab director says the confirmation should be done on the date it was tested. Is this correct. Or should we code both codes and attach a 51 mod to the G0483?
SuperCoder Answered Tue 31st of January, 2017 01:43:51 AM

Hi,

 

It is correct to deny the confirmation test on the date it was tested;  drug confirmation tests are no longer eligible to be separately reported under any procedure code, unlisted codes or otherwise.

 

No separate modifier 51 with HCPCS code G0483 would make it eligible for separate reimbursement.

 

Thank you!

Debra Posted Wed 01st of February, 2017 16:46:23 PM
This did not really answer the question...so do i bill on same date and appeal denials for the 80307 and G0483 billed out same day with no modifer..and get denials. Please understand when the urine is collected we bill that date 80307...the confirmation test is done at a later date and is not a office visit.
SuperCoder Answered Thu 02nd of February, 2017 04:51:27 AM

Hi,

 

Presumptive drug tests, codes 80305 – 80307, cannot be billed with confirmatory drug tests, codes G0480 – G0483. Confirmatory drug tests can only be billed after presumptive drug tests if the presumptive drug test comes back as positive.

Per coding guidelines, if your presumptive drug tests result were positive (80307), then you can bill for your confirmatory test (G0483).   The date of specimen received and the confirmation date has to do nothing with the given scenario.

 

If the presumptive drug tests result were negative, then you can ONLY code 80307.

 

For further details, refer the below link:

 

http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_144353

Related Topics