Coding for drug screening certainly keeps you sharp. Along with all the CPT® codes and rules, you’ve got to remember that Medicare requires use of a separate set of HCPCS codes in 2016. But you may find things a little simpler in 2017.
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Will CPT® 2017 Settle Drug-Screen Coding Once and For All?
1. Will CPT® 2017 Settle Drug-Screen
Coding Once and For All?
2. AddCPT® Codes That Are HCPCS
LookalikesCPT® 2017 deletes presumptive drug class screening codes 80300-80304. A
note in CPT® 2017 says to look instead to new codes 80305-80307.
The new codes’ descriptors look almost identical to the HCPCS codes Medicare
required you to use in 2016, G0477-G0479. The plan is to delete the HCPCS
codes and use the CPT® codes for Medicare.
For the Clinical Lab Fee Schedule (CLFS), the expectation is that the pricing for
the new 2017 codes will be similar to the pricing of their 2016 HCPCS
counterparts.
You’ll want to check HCPCS 2017 and the final CLFS when they’re released to be
sure all of these proposals get finalized, of course.
Here’s a rundown of the new codes. Note that just like the HCPCS codes you’ve
been using, the CPT® descriptors specify that:
The codes include sample validation (such as pH, specific gravity, and
nitrite) if performed
142 deletionsThe codes apply once per date of service
Coding for drug screening certainly keeps
you sharp. Along with all the CPT® codes
and rules, you’ve got to remember that
Medicare requires use of a separate set of
HCPCS codes in 2016. But you may find
things a little simpler in 2017
3. Apply 80305 for Direct Optical
Observation
When the analyst visually reads the results of the test, you’ll use 80305 (Drug test[s],
presumptive, any number of drug classes, any number1 of devices or procedures
[e.g., immunoassay]; capable of being read by direct optical observation only [e.g.,
dipsticks, cups, cards, cartridges] includes sample validation when performed, per
date of service
Code 80305 replaces G0477.
4. Select 80307 for Instrumented Chemistry
Analyze
The final code in the new group is appropriate when the analyst uses any of a large number of
methods requiring instrument chemistry analyzers. The code is 80307 (Drug test[s], presumptive,
any number of drug classes, any number of devices or procedures, by instrument chemistry
analyzers [e.g., utilizing immunoassay (e.g., EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA)],
chromatography [e.g., GC, HPLC], and mass spectrometry either with or without chromatography,
[e.g., DART, DESI, GC-MS, GC-MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF] includes sample
validation when performed, per date of service).
Code 80307 is modeled on G0479, but the list of examples is more extensive in 80307’s descriptor.
The CPT® guidelines explain that some of the methodologies listed in the example are also in use
for definitive drug testing. The presumptive method, however, does not definitively identify the drug.
5. In your CPT® manual, you’ll notice that the presumptive Drug Class Screening and Definitive Drug Testing
codes continue to remain out of numerical order in the lab section of CPT® . Each code is marked with # to
indicate the code is placed in the section based on the nature of the service rather than being in numerical
order.
The codes come after Organ or Disease-Oriented Panels code 80076 and before Therapeutic Drug Assays
code 80150.
Here’s Where You’ll Find the New Codes
How About You?
Are you a lab coder? Do you think these changes will finally bring some stability to coding for drug
screening?
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