Anna, I would review the Medicare local coverage determination policy for the geographical area you are located in, Medicaid policies, and other private payers to correlate the criteria for coverage with ICD-10 codes that most appropriately describe the patient circumstance which a drug test might be required in the course of treatment. Below for example Z79.891 is described in WPS Medicare J5 local coverage determination policy for drug testing. Z79.891 containing the similar to code descriptor as previous ICD-9-CM code V58.69.
ICD-10 Codes that Support Medical Necessity
Group 1 Paragraph: For monitoring of patient compliance in a drug treatment program, use diagnosis code Z03.89 as the primary diagnosis and the specific drug dependence diagnosis as the secondary diagnosis.
For the monitoring of patients on methadone maintenance and chronic pain patients with opioid dependence use diagnosis code Z79.891, suspected of abusing other illicit drugs, use diagnosis code Z79.899.
Group 1 Paragraph: New Codes effective 01/01/2016
G0477 Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures, (eg.immunoassay) capable of being read by direct optical observation only (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service.
G0478 Drug tests(s), presumptive, any number of drug classes; any number of devices or procedures, (eg, immunoassay) read by instrument-assisted direct optical observation (eg, dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service.
G0479 Drugs tests(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers (eg, immunoassay, enzyme assay TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when performed, per date of service.
G0480 Drug tests(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and enzymatic methods (eg, alcohol dehydrogenase)); qualitative or quantitative, all sources, includes specimen validity testing, per day, 1-7 drug class(es), including metabolite(s) if performed.
G0481 Drug tests(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays (eg, IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase)); qualitative or quantitative, all sources, includes specimen validity testing, per day, 8-14 drug classes (es), including metabolite(s) if performed.
G0482 Drug test(s) definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily sterioisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS ( any type, single or tandem and excluding immunoassays (e.g., IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (e.g., alcohol dehydrogenase)); qualitative or quantitative, all sources, includes specimen validity testing, per day, 15-21 drug classes, including metabolites(s) if performed.
G0483 Drug test(s) definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily sterioisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS ( any type, single or tandem and excluding immunoassays (e.g., IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (e.g., alcohol dehydrogenase)); qualitative or quantitative, all sources, includes specimen validity testing, per day, 22 or more drug classes, including metabolites(s) if performed.
The following CPT codes are Non-Covered by Medicare
Group 1 Codes:
80300 DRUG SCREEN, ANY NUMBER OF DRUG CLASSES FROM DRUG CLASS LIST A; ANY NUMBER OF NON-TLC DEVICES OR PROCEDURES, (EG, IMMUNOASSAY) CAPABLE OF BEING READ BY DIRECT OPTICAL OBSERVATION, INCLUDING INSTRUMENTED-ASSISTED WHEN PERFORMED (EG, DIPSTICKS, CUPS, CARDS, CARTRIDGES), PER DATE OF SERVICE
80301 DRUG SCREEN, ANY NUMBER OF DRUG CLASSES FROM DRUG CLASS LIST A; SINGLE DRUG CLASS METHOD, BY INSTRUMENTED TEST SYSTEMS (EG, DISCRETE MULTICHANNEL CHEMISTRY ANALYZERS UTILIZING IMMUNOASSAY OR ENZYME ASSAY), PER DATE OF SERVICE
80302 DRUG SCREEN, PRESUMPTIVE, SINGLE DRUG CLASS FROM DRUG CLASS LIST B, BY IMMUNOASSAY (EG, ELISA) OR NON-TLC CHROMATOGRAPHY WITHOUT MASS SPECTROMETRY (EG, GC, HPLC), EACH PROCEDURE
80303 DRUG SCREEN, ANY NUMBER OF DRUG CLASSES, PRESUMPTIVE, SINGLE OR MULTIPLE DRUG CLASS METHOD; THIN LAYER CHROMATOGRAPHY PROCEDURE(S) (TLC) (EG, ACID, NEUTRAL, ALKALOID PLATE), PER DATE OF SERVICE
80304 DRUG SCREEN, ANY NUMBER OF DRUG CLASSES, PRESUMPTIVE, SINGLE OR MULTIPLE DRUG CLASS METHOD; NOT OTHERWISE SPECIFIED PRESUMPTIVE PROCEDURE (EG, TOF, MALDI, LDTD, DESI, DART), EACH PROCEDURE
80320 - 80377 ALCOHOLS - DRUG(S) OR SUBSTANCE(S), DEFINITIVE, QUALITATIVE OR QUANTITATIVE, NOT OTHERWISE SPECIFIED; 7 OR MORE