# Drug Screen Help



## metzger130 (Jan 22, 2015)

Just started coding for pain management and doing the drug screens.  

I have been looking around trying to find an answer to my question and hopefully someone can help. I am wondering what the difference between 80346 and 80347 is. I see that it says 1-12 and 13+, but what do the numbers mean? 

Thank you


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## dwaldman (Jan 22, 2015)

".......Drug classes may contain one or more codes based on the number of analytes."

AMA CPT Changes 2015

The Definitive Drug Classes Listing provides the drug classes, their associated CPT codes, and the drugs included in each class. Each category of a drug class, including metabolite(s) if performed (except stereoisomers), is reported once per date of service. Metabolites not listed in the table may be reported using the code for the parent drug. Drug class metabolite(s) is not reported separately unless the metabolite(s) is listed as a separate category in Definitive Drug Classes Listing (eg, heroin metabolite).


Drug classes may contain one or more codes based on the number of analytes. For example, an analysis in which five or more amphetamines and/or amphetamine metabolites would be reported with 80326. The code is based on the number of reported analytes and not the capacity of the analysis.


Definitive drug procedures that are not specified in 80320-80373 should be reported using the unlisted definitive procedure codes 80375, 80376, 80377, unless the specific analyte is listed in the Therapeutic Drug Assays (80150-80203) or Chemistry (82009-84830) sections.

Clinical Example (80346 )


A 58-year-old female with severe fibromyalgia pain is prescribed 20 mg controlled release oxycodone and 0.5 mg clonazepam twice per day and tests positive for opiates using a qualitative, presumptive direct observation dipstick device. The qualitative dipstick device is negative for benzodiazepines. The patient denies any deviation from dosing instructions for both oxycodone and clonazepam. Before the prescription refill is issued, a urine specimen is sent to the laboratory to confirm the clonazepam metabolite is present or if presumptive results are false negative.

Description of Procedure (80346 )


A quantitative, definitive GC/MS analysis for six common benzodiazepines is performed. Any of the instrumental techniques that are defined as definitive may be use. These are high-complexity tests, such as LC-MS/MS or GC/MS. Exact methodology varies by testing facility, but all are instrumental techniques with the ability to specifically identify individual drugs and metabolites, if tested, within a class and rule out interfering drugs and other substances. See descriptions of definitive tests in the Definitive Drug Testing introductory guidelines.



Results indicate the presence of 7-aminoclonazepam, consistent with the use of clonazepam, a benzodiazepine that is not detected using the dipstick device. From these results, the clinician refills the prescription.

Clinical ExampleClinical Example (80347 )


A 58-year-old female with severe fibromyalgia pain is prescribed 20 mg controlled release oxycodone and 0.5 mg clonazepam twice per day and tests positive for opiates using a qualitative, presumptive direct observation dipstick device. The qualitative dipstick device is negative for benzodiazepines. The patient denies any deviation from dosing instructions for both oxycodone and clonazepam. Before the prescription refill is issued, a urine specimen is sent to the laboratory to confirm the clonazepam metabolite is present or if presumptive results are false negative.

Description of Procedure (80347 )


A quantitative, definitive GC/MS analysis for six common benzodiazepines is performed. Any of the instrumental techniques that are defined as definitive may be use. These are high-complexity tests, such as LC-MS/MS or GC/MS. Exact methodology varies by testing facility, but all are instrumental techniques with the ability to specifically identify individual drugs and metabolites, if tested, within a class and rule out interfering drugs and other substances. See descriptions of definitive tests in the Definitive Drug Testing introductory guidelines.



Results indicate the presence of 7-aminoclonazepam, consistent with the use of clonazepam, a benzodiazepine that is not detected using the dipstick device. From these results, the clinician refills the prescription.



See the Definitive Drug Classes Listing on pages [232-234] for a listing of the more common analytes within each drug class



80346 Benzodiazepines; 1-12


80347 13 or more


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## dwaldman (Jan 22, 2015)

Fifty-eight new definitive drug testing codes (80320-80377, which includes the resequencing of code 83992) arranged by drug classes have been added. Refer to the Definitive Drug Classes Listing table for drugs and metabolites included in each definitive drug class. *If applicable, the number of analytes tested has been included in the code descriptor.*


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## rwagner4645 (Jan 28, 2015)

Dan,
If a laboratory is testing for a quantitative urine lcms drug screen, which CPT's would be billed?
Please help!


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## dwaldman (Jan 28, 2015)

A laboratory utilizing LCMS to produce quantitative drug test result that is considered a definitive result would report from the definitive codes that were released for 2015 by the AMA. Medicare released HCPCS codes that they want used for certain codes instead which are listed also (G codes). 

AMA Definitive Drug Class Procedures

80320 Alcohols 
80321 Alcohol biomarkers; 1 or 2 
80322 Alcohol biomarkers; 3 or more 
80323 Alkaloids, not otherwise specified 
80324 Amphetamines; 1 or 2 
80325 Amphetamines; 3 or 4 
80326 Amphetamines; 5 or more 
80327 Anabolic steroids; 1 or 2 
80328 Anabolic steroids; 3 or more
80329 Analgesics, non-opioid; 1 or 2 
80330 Analgesics, non-opioid; 3-5 
80331 Analgesics, non-opioid; 6 or more 1 or 2
80332 Antidepressants, serotonergic class;1 or 2
80333 Antidepressants, serotonergic class; 3-5 
80334 Antidepressants, serotonergic class; 6 or more 
80335 Antidepressants, tricyclic and other cyclicals; 1 or 2 
80336 Antidepressants, tricyclic and other cyclicals; 3-5 
80337 Antidepressants, tricyclic and other cyclicals; 6 or more
80338 Antidepressants, not otherwise specified
80339 Antiepileptics, not otherwise specified; 1-3 
80340 Antiepileptics, not otherwise specified; 4-6 
80341 Antiepileptics, not otherwise specified; 7 or more 
80342 Antipsychotics, not otherwise specified; 1-3 
80343 Antipsychotics, not otherwise specified; 4-6 
80344 Antipsychotics, not otherwise specified; 7 or more 
80345 Barbiturates 
80346 Benzodiazepines; 1-12 
80347 Benzodiazepines; 13 or more 
80348 Buprenorphine
80349 Cannabinoids, natural 
80350 Cannabinoids, synthetic; 1-3 
80351 Cannabinoids, synthetic; 4-6 
80352 Cannabinoids, synthetic; 7 or more 
80353 Cocaine 
80354 Fentanyl 
80355 Gabapentin, non-blood 
80356 Heroin metabolite 
80357 Ketamine and norketamine 
80358 Methadone 
80359 Methylenedioxyamphetamines (MDA, MDEA, MDMA)
80360 Methylphenidate 
80361 Opiates, 1 or more 
80362 Opioids and opiate analogs; 1 or 2 
80363 Opioids and Opiate analogs; 3 or 4 
80364 Opioids and Opiate analogs; 5 or more 
80365 Oxycodone 
80366 Pregabalin 
80367 Propoxyphene 
80368 Sedative hypnotics (non-benzodiazepines) 
80369 Skeletal muscle relaxants; 1 or 2 
80370 Skeletal muscle relaxants; 3 or more 
80371 Stimulants, synthetic
80372 Tapentadol 
80373 Tramadol
80374 Stereoisomer (enantiomer) analysis, single drug class 
80375 Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3
80376 Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6 
80377 Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more  


Release by Medicare for 2015 

G6030 Amitriptyline Assay of amitriptyline
G6031 Benzodiazepines Assay of benzodiazepines
G6032 Desipramine Assay of desipramine
G6034 Doxepin Assay of doxepin
G6035 Gold Assay of gold
G6036Assay of imipramine Assay of imipramine
G6037 Nortriptyline Assay of nortiptyline
G6038 Salicylate Assay of salicylate
G6039 Acetaminophen Assay of acetaminophen
G6040 Alcohol (ethanol); any specimen except breath Assay of ethanol
G6041 Alkaloids, urine, quantitative Assay of urine alkaloids
G6042 Amphetamine or methamphetamine Assay of amphetamines
G6043Barbiturates, not elsewhere specified Assay of barbiturates
G6044 Cocaine or metabolite Assay of cocaine
G6045 Dihydrocodeinone
G6046 Dihydromorphinone  Assay of dihydromorphinone
G6047 Dihydrotestosterone Assay of dihydrotestosterone
G6048 Dimethadione Assay of dimethadione
G6049 Epiandrosterone Asssay of epiandrosterone
G6050 Ethchlorvynol Assay of ethchlorvynol
G6051 Flurazepam Assay of flurazepam
G6052 Meprobamate Assay of meprobamate
G6053 Methadone Assay of methadone
G6054 Methsuximide Assay of methsuximide
G6055 Nicotine Assay of nicotine
G6056 Opiate(s), drug and metabolites, each procedure
Assay of opiates
G6057 Phenothiazine Assay of phenothiazine
G6058 Drug confirmation, each procedure


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## tolbert4 (May 6, 2015)

*Example G6031*

If they are testing for 13 or more then would you bill the G6031 X2?


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## dwaldman (May 6, 2015)

G6031 Benzodiazepines Assay of benzodiazepines

Since the descriptor describes benzodiazepines in the plural form, it appears only one unit of service would cover 13+ different drugs.


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