2017 Toxicology Laboratory Billing

It seems that toxicology billing is not going to get any simpler.  Already this year, the CMS has reversed themselves for the second year in a row. The qualitative codes G0477, G0478, G0479 were deleted, after being introduced in 2016.  Those codes were replaced with 80305-80307.  These new codes were essentially the same as the old ones, other than the addition of a few more methods of instrumented chemistry analysis. CMS also eliminated the separate validity testing codes 84311, 83986, 82570, the functions of which were rolled up under other existing codes.

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2015 Toxicology Coding Crosswalk

2014-2015 Toxicology Coding Crosswalk    
Nature of Testing/Item Tested 2015 CMS CPT 2015 AMA
CPT
2014
CPT
PRESUMPTIVE DRUG CLASS SCREENING      
    80300  
SCRN-1 -Drug screen, any number of drug classes from Drug Class List A; Direct optical observation, including instrumented-assisted (dipsticks, cups, cards, cartriges), non-TLC devices or procedures per date of service      
    80301  
SCRN - 2 - 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  
SCRN - 3 - 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  
SCRN - 4 - 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  
SCRN - 5 - 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      
CMS IS USING "DRUG SCREEN" EACH PROCEDURE FOR G0431, G0434 G0431   80101
       
       
Acetaminophen G6039 See 80329-80331 82003
Alcohols G6040 80320 82055
Alcohol biomarkers- 1 or 2   80321  
Alcohol biomarkers - 3 +   80322  
Alkaloids; urine; Quantitative G6041 80323 82101
Alkaloids not otherwise specified   80323  
Amitryline G6030 See antidepressants, Tricyclic and other cyclicals; 80335-80337 80152
Amphetamines - 1 to 2 analytes G6042 80324 82145
Amphetamines; 3 or 4   80325  
Amphetamines - 5 or more analytes   80326  
Amobarbital   80345  
Anabolic Steroids - 1 or 2   80327  
Anabolic Steroids - 3 or more   80328  
Analgesics - non-opioids - 1 or 2 drugs   80329  
Analgesics - non-opioids - 3-5 drugs   80330  
Analgesics - non-opioids - 6 or more drugs   80331  
Antidepressants, serotonergic class; 1 or 2 drugs   80332  
Antidepressants, serotonergic class; 3-5   80333  
Antidepressants, serotonergic class; 6 or more   80334  
Antidepressants, tricyclic and other cyclicals; 1 or 2 drugs   80335  
Antidepressants, tricyclic and other cyclicals; 3-5   80336  
Antidepressants, tricyclic and other cyclicals; 6 or more   80337  
Antidepressants, not otherwise specified   80338  
Antiepileptics, not otherwise specified; 1-3 drugs   80339  
Antiepileptics, not otherwise specified; 4-6   80340  
Antiepileptics, not otherwise specified; 7 or more   80341  
Antipsychotics, not otherwise specified; 1-3 drugs   80342  
Antipsychotics, not otherwise specified; 4-6   80343  
Antipsychotics, not otherwise specified; 7 or more   80344  
Barbiturates G6043 80345 82205
Barbiturates, qualitative   80345  
Benzodiazepines; 1-12 G6031 80346 80154
Benzodiazepines; 13 or more G6031 80347  
Buprenorphine and metabolites   80348  
Cannabinoids, natural   80349  
Cannabinoids, synthetic; 1-3   80350  
Cannabinoids, synthetic; 4-6   80351  
Cannabinoids, synthetic; 7 or more   80352  
Carbon tetrachloride 82441 82441 84600
Cocaine or metabolite G6044 80353 82520
Cocaine, qualitative   80353  
Codeine, qualitative   See Opiates; 80361  
Desipramine G6032 See Antidepressants, Tricylic and other cyclicals; 80335-80337 80160
Dichloroethane 82441 82441 84600
Dichloromethane 82441 82441 84600
Dihydrocodeinone G6045 See 80361 82646
       
Dihydromorphinone G6046 See 80361 82649
       
Doxepin G6034 Antidepressants, Tricylic and other cyclicals; 80335-80337 80166
DRUG CONFIRMATION, EACH PROCEDURE     80102
Epiadrosterone G6049 See Anabolic Steroids; 80327-80328 82666
Ethchlorvynol G6050 See Alcohols; 80320 82690
Fentanyl and metabolite   80354  
Flurazepam G6051 See Benzodiazepines; 80346-80347 82742
       
Gabapentin (non-blood)   80355  
Heroin Metabolite (6-Acetylmorphine)   80356  
       
Imipramine G6036 See antidepressants, Tricyclic and other cyclicals; 80335-80337 80174
Isopropyl Alcohol   See Alcohols; 80320 84600
Ketamine and norketamine   80357  
Marihuana   See cannabinoids, natural 80349  
Meprobamate G6052 See Skeletal muscle relaxants; 80369, 80370 83805
Meprobamate QUALITATIVE   See Skeletal muscle relaxants; 80369, 80370  
Methanol   See Alcohols; 80320 84600
Methadone and metabolite G6043 80358 83840
Methylenedioxyamphetamines (MDA, MDEA, MDMA)   80359  
Methylphenidate   80360  
Methsuximide G6054 See Antipipleptics, NOS; 80339-80341 83858
Nicotine G6055 See Alkaloids, nos; 80323 83887
Nortriptyline G6037 See Antidepressants, Tricyclic and other cyclicals; 80335-80337 80182
Opiates, drug AND metabolites; Each procedure, including nalorphine) G6056 See Opiates; 80361 83925
Opiates, 1 or more G6056 80361  
Opioids and opiate analogs; 1 or 2 G6056 80362  
Opioids and opiate analogs; 3 or 4 G6056 80363  
Opioids and opiate analogs; 5 or more G6056 80364  
Oxycodone   80365  
Phencyclidine   83992  
Phenothiazine G6057 See Antipsychotics, NOS; 80342-80344 84022
Phenothiazine, qualitative   See Antipsychotics, NOS; 80342-80344  
Pregabalin   80366  
Propoxyphene and metabolite   80367  
Salicilates G6038 See Analgesics, non-opioid; 80329-80331 80196
Sedative hypnotics (non-benzodiazepines)   80368  
Skeletal muscle relaxants; 1 or 2   80369  
Skeletal muscle relaxants; 3 or more   80370  
Stimulants, synthetic   80371  
Tapentadol and metabolite   80372  
Tramadol and metabolite   80373  
Stereoisomer (enantiomer) analysis, single drug class   80374  
       
CATCHALL      
Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1 to 3   80375  
Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4 to 6   80376  
Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more   80377  
       
THERAPEUTIC      
Digoxin; free 80163 80163  
Valproic acid (dipropylacetic acid); free 80164 80164  
       
UNCLASSIFIED TO DATE OR WILL FALL INTO CATCHALL      
11 Cotinine   See Alkaloids, NOS, 80323  
12 Desomorphine (Krokodil)   See Opioids and opiate analogs; 80362-80364  
13 Dextromethorphan (DXM)   See Opioids and opiate analogs; 80362-80364  
20 Methamphetamine   See Amphetamines; 80324-80326  
22 Mitragynine   See Alkaloids, NOS, 80323  
27 Phencyclidine (PCP)   83992  
32 Synthetic Cathinones (Bath Salts)   See stimulants, synthetic; 80371  

 

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