Pathology/Lab Coding Alert

Question: We have physician clients from a rehab facility that frequently order our standard drug screen panel, plus an additional quantitative test for the treatment drug, Suboxone. We perform the qualitative multi-drug screen using chromatography, but must separately run the quantitative Suboxone test using a liquid chromatograph/mass spectrometer. How should we bill for the testing?

California Subscriber

Answer: For non-Medicare payers, report the chromatographic drug screen using 80100 (Drug screen, qualitative; multiple drug classes, chromatographic method, each procedure). Because the Suboxone test is a quantitative analysis, you should list that service using 83925 (Opiate[s], drug and metabolite[s], each procedure).

CPT® defines each "procedure" for 80100 as each chromatographic stationary and mobile phase. That means you'll report 80100 if the test detects multiple drugs using a single stationary/mobile phase. But you should list multiple units of 80100 if the drug detection involves one stationary phase with multiple mobile phases.

Because the Suboxone test is not a qualitative or confirmatory test, you should not use another drug screen code such as 80100 or 80102 (Drug confirmation, each procedure) to report the service.

As with 80100, the unit of service for 83925 is the procedure, which refers to a single mobile and stationary phase for chromatographic tests. If the quantitative analysis for Suboxone (buprenorphine with naloxone) requires two mobile phases, report two units of 83925.