Pathology/Lab Coding Alert

Question: Our lab performs urine drug testing by dipstick for multiple drugs as part of a Suboxone detox program for opioid dependence. I’ve been told we should code 80101, 80102, or G0434-QW. Which code is correct?

Florida Subscriber

Answer: The method you describe does not fit either 80101 (Drug screen, qualitative; single drug class method [e.g., immunoassay, enzyme assay], each drug class) or 80102 (Drug confirmation, each procedure). 

Code 80101 describes a complex lab method that most likely involves a chemistry analyzer that evaluates different drug classes individually. The test you describe is a low-complexity dipstick method that checks for multiple drug classes in a single procedure.

Code 80102 is reserved for reporting additional confirmation testing after a drug screen returns positive findings.

But rejecting 80101 and 80102 doesn’t mean you should automatically report G0434 (Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter) with modifier QW (CLIA waived test). 

Watch QW: You should report modifier QW with G0434 only if the test is CLIA waived, and you’ll notice that you can also report a moderate complexity test with G0434.

Although G0434 is the correct code if Medicare is the payer, many other payers don’t accept the HCPCS Level II codes. For those payers, you’d be better off reporting 80104 (Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure) for the test you describe.