Wiki Need help with 80305 diagnosis

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celiaw

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Help! I am new to a pain management practice where they frequently do urine tests. We use 80305 to bill the test and the ICD 10's that are typically mapped with the CPT are F11.20, Z51.81 and Z79.891. I was reviewing accounts and a lot of patient's have the F11.20 attached which from my understanding is an opioid dependence ICD code. Is it normal for this code to be used so frequently? If not, what code could I use to replace it, I'm not sure all insurances will pay the CPT with only Z51.81 and Z79.891 attached.

Please, any tips or help is very appreciated!!!! Trying to get this practice back to a healthy balance!
 
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celiaw said:
Help! I am new to a pain management practice where they frequently do urine tests. We use 80305 to bill the test and the ICD 10's that are typically mapped with the CPT are F11.20, Z51.81 and Z79.891. I was reviewing accounts and a lot of patient's have the F11.20 attached which from my understanding is an opioid dependence ICD code. Is it normal for this code to be used so frequently? If not, what code could I use to replace it, I'm not sure all insurances will pay the CPT with only Z51.81 and Z79.891 attached.

Please, any tips or help is very appreciated!!!! Trying to get this practice back to a healthy balance!
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I am not pain management but we do these drug screens for our ADD/ADHD patients or any patient that is on a controlled substance and the way were are able to get them paid is using Z79.899 as the primary dx and then we use the dx as to which they are on a controlled substance for example
Z79.899, F90.2 or Z79.8999, F41.1
 
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rthomas@impcna.com said:
I am not pain management but we do these drug screens for our ADD/ADHD patients or any patient that is on a controlled substance and the way were are able to get them paid is using Z79.899 as the primary dx and then we use the dx as to which they are on a controlled substance for example
Z79.899, F90.2 or Z79.8999, F41.1
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Thank you so much for responding. I believe we are going to try your method!! I appreciate you! :)
 
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celiaw said:
Based off of the providers progress notes it does not appear that the patient has any history of opioid abuse.
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Opioid dependence and opioid abuse are not the same thing.

Dependence is the reliance on the medication to treat a problem. Think insulin dependence.

Abuse is using the medication in a manner that was not intended.
 
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If the patient has been prescribed Opioids for pain management and is being monitored for compliance, use ICD10 Code Z79.891 - Long term (current) use of Opiate Analgesic
 
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