CPT 2010 Preview:
Paid Per Drug Class for Test Kits? That's About to End
Published on Tue Sep 01, 2009
You'll get less pay for low complexity drug screen. This winter a pair of G codes may replace CPT drug screen codes that paid you the same regardless of the test's complexity. Drug Screens Are Not Created Equal CMS is about to put an end to an unfair pricing practice. CPT lacks a distinct code for drug screen kits. Therefore, labs that perform a low-complexity test waived under the Clinical Laboratory Improvement Amendments (CLIA) currently garner the same pay as labs that perform a high-complexity drug screen on a manual or automated chemistry platform. Problem: The following two codes are the only ones that labs currently have to bill for drug screens: • 80100 -- Drug screen, qualitative; multiple drug classes chromatographic method, each procedure • 80101 -- ... single drug class method (e.g., immunoassay, enzyme assay), each drug class. Currently, Medicare pays $21.23 for 80100 and $20.11 for 80101 on the [...]