Primary Care Coding Alert

Question: Is there an ICD-9 diagnosis we can use to code for urine drug screening?

New York Subscriber

Answer: ICD-9 does not provide a specific code for urine drug screening.

Therefore, it is important to establish the medical necessity for requesting a urine drug screening. This could either be for a general screening drug test or to screen for a specific drug based on known history of drug use or signs and symptoms manifested by the patient.

For general screening purposes, use this code for urine drug screening:

• V70.3 -- General medical examination; other medical examination for administrative purposes.

For example, an FP orders a urine drug screening for an elderly patient prior to being admitted to an old age home. Patient has no known history of drug abuse nor shows any signs and symptoms of drug dependence or withdrawal. Therefore, a V code (V70.3) will be appropriate as the primary diagnosis. If, on the other hand, the test was requested for a specified reason, then code for the specific diagnosis. For example, a high school student previously diagnosed as marijuana dependent is doing poorly in school and was brought by concerned parents to his family physician because they suspect he is using marijuana again. The family physician orders a urine drug screening. In this case, the most appropriate code will be:

• 304.30 " Drug dependence; cannabis dependence, unspecified use.

-- Information for and answers to You Be the Coder and Reader Questions reviewed by Kent Moore, manager of health care financing and delivery systems for the American Academy of Family Physicians in Leawood, Kan.