Reader Question:
Payer Preference Helps Guide Correct 80101 Reporting
Published on Sun Nov 11, 2012
Question: Our pain management physicians perform random drug screenings, and I have a question about the correct way to bill 80101. Do we bill only one unit, or can we bill multiple units if they test for multiple drugs? Kansas Subscriber Answer: Report the codes based on the type of test or test kit your provider uses, and payer requirements.Submit 80104 (Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure) for the drug screen testing using a cup, cassette or dipstick that tests for multiple drugs/drug classes with one test kit, i.e. a cup that tests for 9 different drug classes. In this example, the provider would bill 80104 x 1 unit of service. Remember you report 80104 for the diagnostic lab test, not the test kit.By contrast, use 80101 (Drug screen, qualitative; single drug class method [e.g., immunoassay, enzyme assay], each drug class) to report drug [...]