ED Coding and Reimbursement Alert

Question: A patient presents to the ED with a police escort. An officer tells the front desk that the patient is there for a court-ordered drug test for cocaine. How should I code this encounter? Texas Subscriber Answer: When the patient is ordered to submit to a procedure or service, attach modifier 32 (Mandated services) to the CPT code. This lets the payer know that the service is "related to mandated consultation and/or related services (e.g., third-party payer, governmental, legislative or regulatory requirement)," according to the CPT 2008 manual. On the claim, report the following: - 80100 (Drug screen, qualitative; multiple drug classes chromatographic method, each procedure) for the screening - 80102 (Drug confirmation, each procedure) for the confirmation - modifier 32 linked to 80100 and 80102 to show that the tests were ordered. Note: You may also wish to append V70.4 (Examination for medicolegal reasons) or V62.5 (Persons encountering health services; legal circumstances) to the screening codes.