Pathology/Lab Coding Alert

Question: We're a physician office lab, and we had one of our doctors order a drug "screening" for a patient whom he described as "in a daze, insensible." I thought a screening had to be without signs or symptoms. The lab ran an Abbott Diagnostics Signify ER Drug Screen for amphetamines, barbiturates, benzodiazepines, cocaine metabolites, MDMA, opiates, oxycodone, PCP, propoxyphene, THC, tricyclic antidepressants. How should we code this?

Codify Subscriber

Answer: The correct procedure code for this test is 80305 (Drug test(s), presumptive, any number of drug classes, any number of devices or procedures (eg, immunoassay); capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges) includes sample validation when performed, per date of service). You should append modifier QW (CLIA waived test) to indicate that this is an approved test for a physician office lab operating with a certificate of waiver under the Clinical Laboratory Improvement Amendments (CLIA).

Regarding the ordering diagnosis, you should report the symptom that prompted the test, as noted by the physician, such as R40.1 (Stupor). You should not report this drug screen using a diagnosis such as Z02.83 (Encounter for blood-alcohol and blood-drug test). Reserve Z02.83 for screenings that the physician orders in the absence of signs or symptoms that cause the suspicion of drug use.