# Drug screening for medicaid



## ldittman01@yahoo.com (Sep 4, 2013)

Ok what is the correct cpt code for drug screening?  I use 80101 for commercial and G0434 for medicare, so which code do I use for medicaid??  They have rejected both of these cpt codes.


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## skweston (Sep 5, 2013)

Florida Medicaid accepts 80101 up to 7 units. What state are you in?


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## KMCFADYEN (Sep 5, 2013)

We bill 80104 QW to straight Medicaid in Virginia and they pay.  If it is a replacement Medicaid plan that is an HMO, they will not pay with any code.


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## skweston (Sep 5, 2013)

I would agree with that 80104 since that is the newer code that should be used. I however have noticed that not many insurance companies recognize it yet. Anyone else have that problem?


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## capricew (Sep 5, 2013)

@skweston-
sorry, but I do not agree that 80104 should be used just because it is the newer code.
 80101/g0431 is for drug screening when each drug class is tested individually.
80104/g0434 is for drug screening when a multi test kit is used to test multiple drug classes by one method.

You really need to know how your lab is processing these tests..... whether they are doing each assay individually with a different reagent or whether they are testing mulitple drugs with one method.

Hope this helps


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## dwaldman (Sep 5, 2013)

The part of initial post makes me question what you are reporting.

If you are using G0434 that means you are billing a drug test kit or potentially an in office analyzer of moderate complexity.

80101 would typically be for test performed in a reference lab where for Medicare they are reporting G0431 for the same type of test they are billing. 

What method of drug testing are you performing. If all that is being performed is a the utilization of a drug test kit, you would not ever report 80101.

I am not aware of your situation but it is highly important that you do not bill 80101 for a drug test kit. Because this would be improper billing. Since 80104 was established to report a drug test kit. 

Maybe your situation is different but the way you started out the initial post draws immediate questions in my mind.


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## KMCFADYEN (Sep 6, 2013)

We only bill 80104 QW to straight medicaid and United Healthcare.  For all other insurance we bill G0434 QW.  We have no problems with reimbursement when billed this way.


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## suemt (Nov 7, 2013)

Here is an MLN description of Medicare Drug Screen Testing that gives a very good explanation of the different tests and which code to use.  

http://www.cms.gov/Outreach-and-Edu...k-MLN/MLNMattersArticles/downloads/SE1105.pdf


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