You would need to contact the Lab and talk to for example the toxicology director or your representative assigned to you from the lab. Say that you need to know their test method----is it?----they are testing a single drug class using immunoassay or enzyme assay in a single run. So in essense if they are testing five drug classes, they are doing 5 procedures. Versus testing that is other than chromographic that simulatneously tests multiple drug classes. I think once you have in writting what type of testing they are doing then you confirm the appropriate code to bill. We also have the same scenario you are describing of doing the drug test kit as "initial field test" then sending the specimen within the kit to the lab so they can provide a report do their style of testing. We are in process of confirming what type of testing they are performing. Still a lot to review before we will be able to bill for any drug tests for 2011. Sending to the lab and doing our own billing makes a lot more in depth understanding that we are still looking to acquire.
It is interesting that you can go back eleven years a look at the CPT Assistant article for drug testing and things that I did not pay much attention to when it was just 80101 x classes. Now I am trying to better understand it when there are more codes, more involvement with AMA and CMS with modifications, and still more questions.
__________________________________________________________
2010 CPT Assistant March
For example, immunoassays, which are used to identify single drug classes, should be coded using 80101 (when used in drug screening), whether the test is performed using a random access analyzer, a single analyte test kit, or a multiple analyte test kit. Chromatography, which can identify multiple drug classes, is coded using 80100 (when used in drug screening).
For code 80100, each combination of stationary and mobile phase is to be counted as one procedure. For example, if screening for three drugs by chromato-graphy requires one stationary phase with three mobile phases, report 80100 three times. However, if multiple drugs can be detected using a single analysis (eg, one stationary phase with one mobile phase), report 80100 only once.
For code 80101, each single drug class method tested and reported is to be counted as one drug class. For example, if a sample is aliquoted to five wells and separate class-specific immunoassays are run on each of the five wells and reported separately, report 80101 five times. Similarly, if a sample is run on a rapid assay kit comprising five class-specific immunoassays in a single kit, and the five classes are reported separately, code 80101 should be reported five times.
80101, Drug, screen; single drug class, each drug class. A 30-year-old female, with a history of anxiety and depression treated with prescription medications, comes to the ED in a coma. The treating physician orders a drug screen for alcohol, barbiturates, benzodiazepines, phenothiazines, and tricyclic antidepressants. The laboratory performs single drug class screening for each analyte using immunoassay or enzyme assay methods in a random access analyzer.
To code this you would use 80101 times five, because this code is used to report immunoassay and enzyme assay, single drug class methods. Five units are reported as each single drug class is reported separately.
80101, Drug, screen; single drug class, each drug class. A 25-year-old male with a history of illegal drug use comes to the ED in a coma. The treating physician orders a drug screen for amphetamines, barbiturates, benzodiazepines, cocaine and metabolites, opiates, phencyclidine, and tetrahydrocannabinoids. The laboratory performs single drug class screening for each analyte using a multiple analyte rapid test immunoassay kit.
To code this you would use 80101 times seven, because immunoassay single drug class methods are reported using this code regardless of platform (random access analyzer or multiple analyte test kit). Seven units are reported as each single drug class is reported separately.