Wiki G0431 vs 80301/80302

[Cavalier40]

Hopefully I can clear up some questions.

What is the difference between G0431 and 80301? The descriptions seem to be almost the same and can use the same methodology to get a presumptive drug screening.

Also can 80301 and 80302 be billed in the same instance? Our panels span over both list A and list B.

Has there been any word if any of this is going to cleaned up in 2016?

Thanks for any help.

 

[Walker22]

Hopefully I can clear up some questions.

What is the difference between G0431 and 80301? The descriptions seem to be almost the same and can use the same methodology to get a presumptive drug screening.

Also can 80301 and 80302 be billed in the same instance? Our panels span over both list A and list B.

Has there been any word if any of this is going to cleaned up in 2016?

Thanks for any help.

80301 and 80302 can be billed together if tests from both lists are done. G0431 is Medicare's code for presumptive testing. Medicare did not approve of the descriptors for 80301 and 80302, so they created their own code (G0431). This will not be cleaned up for 2016. 80301 and 80302 will continue to be used by commercial payers, and G0431 is being replaced by G0479 for Medicare.

 

[Cavalier40]

Thanks for the info.

is G0749 a 2016 code? I did not see it in my 2015 HCPCS book.

 

[traceydrvr71]

80301/80302 and G0431

I have a quick question, if the 80301/80302 is the code for "commercial" insurance and G0431 is for Medicare, would it be safe to assume these codes should not both be present on the same claim? Also, since they state "any number of" and/or "multiple" can they be billed with a quantity?

 

[Walker22]

Thanks for the info.

is G0749 a 2016 code? I did not see it in my 2015 HCPCS book.

Medicare has published their intent to use this code in 2016, but I have not seen the 2016 HCPCS book yet. It will be a new code for 2016. It is not in the 2015 book.

 

[Walker22]

I have a quick question, if the 80301/80302 is the code for "commercial" insurance and G0431 is for Medicare, would it be safe to assume these codes should not both be present on the same claim? Also, since they state "any number of" and/or "multiple" can they be billed with a quantity?

You would not have 80301/2 and G0431 on the same claim, since they describe essentially the same services. 80301 and G0431 would be billed with a unit of 1. 80302 would be billed in units depending on how many drugs on list B are tested.

 

[skweston]

Any instances when billing both 80301 and 80302 on same claim being denied as bundled? I have some denials from our Medicaid payers stating that 80301 is bundled with 80302 and they are only paying on the 80302? State of Florida Medicaid does not recognize any of the G codes as of yet. Thank you.