Wiki drug testing and getting paid by medicare and medicaid for G0478 Drug test

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seanaenae

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G0478 Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service

im using this code with a QW MODIFIER AND DX CODE Z79.899
its not getting paid by the insurance does anyone know if this code is reimbursable.
 
That is going to vary by payer, so there is no way to answer your question. What is the denial reason that they are giving for not reimbursing the code?
 
The denial is saying not covered by payor or not reimbursable under policy. My provider wants to give the drug test but i dont think its covered.... Medicaid stated that it was covered under them if the patient was medi medi.
 
We have had patients sign an abn and then drop the charge to the patient after its denied... I really dont see the medical neccesity for the test. Unless the doctor really feels it is.
 
Im trying to verify that the code i am using it correct and the dx is correct. And i am trying to see if medicare pays this code.... True blue is that 4/ 2015 or did you mean 4/2016? Can you explain more please im interested on what those dates mean. Thank you
 
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