Tuesday, September 14, 2010

DRUG screen CPT codes 80100, 80101, 80102

Drug Testing Codes 

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
Quantitative assays should be coded using the appropriate method code or 83520 (immunoassay, other than antibody or infectious agent antigen, quantitative, not otherwise specified).
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
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Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download