The following codes are to be used for qualitative instrumental methods:
- 80100 DRUG SCREEN: multiple classes, each procedure
- 80101 DRUG SCREEN: single class, each procedure
- 80102 DRUG CONFIRMATION: each procedure
CPT code 80100 or 80101 is used for the initial screen, depending on whether the method detects multiple classes or a single class of drugs. Each confirmatory identification procedure is coded separately using 80102. These codes may be used in addition to the codes listed in the Therapeutic Drug Assay section of the CPT if the drug(s) determined qualitatively is subsequently quantified.
For example, an overdose of phenobarbital is suspected after obtaining a positive result for a urine screen for barbiturates. A quantitative serum assay for phenobarbital is then performed. Coding would be as follows:
- 80101 DRUG SCREEN: single class (Barbiturates)
- 80184 PHENOBARBITAL
Urine Drug Screens
Laboratory providers are classified as independent allied providers who are CLIA certified for the sole purpose of performing laboratory services. Laboratory providers who perform urine drug screens using instrumented systems should report the following codes:
These procedures are limited to one unit per date of service.
• 80100 (Drug screen)
• G0431 (Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay, per patient encounter)
We will only reimburse for one test when a single testing mechanism is used to screen for multiple drug classes.
This procedure is limited to one unit.
• 80101 (Drug screen)
Please Note: Only positive qualitative drug screens can be confirmed with quantitative drug confirmation codes. Only one unit for each drug confirmation test will be allowed.
Routine periodic audits will be performed. Providers discovered to be billing inappropriately will be subject to a more detailed review and possible recoupment of overpayment.