BC Advantage - 2015 Issue 5

Qualitative Drug Screen Testing 2015 Change in CPT Codes

The Centers for Medicare & Medicaid Services has changed the CPT guidelines for reporting qualitative drug-screen testing in a physician's office. As of January 1, 2015 CPT codes 80100, 80101 and 80104 will not be eligible for reimbursement when the services are billed on POS 11. Accordingly, qualitative drug screen testing is only eligible for reimbursement when reported with Healthcare Common Procedure Coding System Level II (HCPCS) codes G0431 and/or G0434. Both codes G0431 and G0434 will be eligible for one (1) unit of reimbursement per date of service. Therefore: G0431 replaces CPT codes 80100 and 80101G0434 replaces CPT...

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