Pathology/Lab Coding Alert

Question: We’re using the new CPT^® code for drug screening, 80305, instead of the old code, G0477. But the diagnosis code we’ve been using, Z79.899, is not valid with 80305. What should we do?

Codify Subscriber

Answer: The correct diagnosis code for a drug test ordered as a screening exam with no other symptoms or extenuating factors is Z02.83 (Encounter for blood-alcohol and blood-drug test).

The code you mentioned (Z79.899, Other long term [current] drug therapy) describes a situation where the physician orders a drug test for a specific substance because the patient has been taking the drug therapeutically. You should not report a drug test to monitor blood levels of a specific therapeutic agent with 80305 (Drug test[s], presumptive, any number of drug classes, any number of devices or procedures [e.g., immunoassay]; capable of being read by direct optical observation only [e.g., dipsticks, cups, cards, cartridges] includes sample validation when performed, per date of service). Code 80305 describes a drug screen, typically for multiple drug classes, typically when current drug use is unknown.

Option: If the physician orders a drug screen based on a symptom indicating suspicion of drug use, you should report the appropriate symptom code, such as R40.0 (Somnolence) or R40.1 (Stupor).