Spsparke,
What is you office's scenario?
Are using for example, 11 panel CLIA drug test kit. Having the nurse adminster the test. Using a drug test worksheet to mark the postive and negatives. Then bill G0434 for Medicare/Medicare replacements (Evercare, Care improvement plus, Secure Horizaon, Humana Gold Plus, Coventry Advantra, etc..) or 80104 for commercial or non medicare payers.
Have you ran into the predictment that QW is not on the clinicla lab fee schedule next to
G0434. And getting denials that QW is a invalid modifier with G0434. I would assume that the did not put the a line for G0434 QW by error. Whereas they created G0431 and G0431 QW which would be less likely that the office would be doing high complexity testing.
Are you do the drug test panel then sending the specimen within the drug test kit to a lab to run the specimen and provide an official report and a more reliable test method than the drug test kit. Has the lab relayed how their test method measures on the complexity scale. Are their prices past on what drug test would be reimburse in 09' or 10' and is not consider feasible with the new codes/new reimbursement.
These are some things that come to mind. Without knowing the exact process or sceanario in which you office does the drug testing, mainly is each specimen going to the lab. It is hard to know which things to point out to consider. To me, if you are only do a drug test kit in the office that is not be sent to a lab then the current reimbursement for
G0434 would cover the cost of doing this and I don't know much more you could do to change to report it better. If you are doing only a drug test kit in the office not sending it to the lab, the CPT manual seems to be pretty straightforward that 80104 is the code to report. And I assume the carriers reimbursement for 80104 would cover the cost of the test. For me, alot of the questions start coming when sending it to the lab to confirm results and the costs from the lab. And covering those costs with G0434 or 80104.