Wiki Drug monitering

[Linda McMann]

Our physicians do regular drug testing on patients on long-term Percocet, Oxycodone, etc to make sure patients are not taking illicit drugs with them or diverting the prescribed drugs [ ie: selling them, not taking them]. We use HCPCS code G0434 for Medicare products and 80104 for all non-Medicare insurance products. Medicare covers this with V58.69, but other insurances are denying coverage for this dx. What dx are any of you other coders using? And are you getting paid w/ them? We are concerned about labeling patients as drug dependent although, at least in layman terms, perhaps that is accurate. I'd appreciate some feedback on this issue. Thank you.

 

[mitchellde]

V58.69 is a secondary only code, you need to use the V58.83 first followed by the V58.69. The patients are not drug dependent if the drugs are being therapeutically prescribed and taken correctly.