Will CPT® 2017 Settle Drug-Screen Coding Once and For All?

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

Apply 80305 for Direct Optical ObservationWhen  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.

Select 80307 for Instrumented Chemistry AnalyzeThe 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.

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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