FIRST COAST SERVICE OPTIONS
LOCAL COVERAGE DETERMINATION
CODING GUIDELINES
Contractor’s
Determination Number
G0431
LCD Database ID
Number
L30574
Contractor Name
First
Coast Service Options, Inc.
Contractor
Number
09102 –
09202 – Puerto Rico
09302 –
LCD Title
Qualitative Drug
Screening
Coding
Guidelines
Effective April 1, 2010, when
performing a qualitative drug screening test for multiple drug classes that use
chromatographic methods. CPT code
80100 is the appropriate code to bill. HCPCS
code G0430 was created to limit the billing to one time per procedure and to
remove the limitation of the method (chromatographic). Therefore, when a clinical laboratory that does
not require a CLIA certificate of waiver performs a qualitative drug
screening test for multiple drug classes that does not use chromatographic
methods, HCPCS code G0430 is the appropriate code to bill. When a clinical laboratory that does
require a CLIA certificate of waiver performs a qualitative drug screening test
for multiple drug classes that does not use chromatographic methods, HCPCS code
G0430QW is the appropriate code to bill.
Effective April 1, 2010,
HCPCS code G0431 should be utilized by those clinical laboratories that do
not require a CLIA certificate of waiver.
Those clinical laboratories that do require a CLIA certificate of
waiver should utilize HCPCS code G0431QW.
Effective January 1, 2011,
HCPCS code G0430 was deleted and replaced with HCPCS code G0434 – Drug screen,
other than chromatographic; any number of drug classes, by CLIA waived test or
moderate complexity test, per patient encounter. In addition, CPT code 80100 is no longer a
valid code for Medicare
purposes and HCPCS code G0431 should be billed when applicable.
Use CPT code 80102
for drug confirmation.
For management of patients under treatment of
substance abuse or management of patients with chronic pain, point of service
qualitative urine drug screen is the most frequently utilized testing. This testing is described by G0434 and is billed
one unit per patient encounter.
Comments
N/A
Revision History
|
Date |
Revision |
|
02/13/2011 |
3- Under the “Coding Guidelines” section,
language was added to clarify point of service qualitative urine drug screen
for number of units billed. Also, based on CR7300, effective 1/1/2011, CPT
code 80100 was noted as no longer being a valid code. The effective date of this Coding
Guidelines revision is based on date of service. |
|
01/01/2011 |
2 – January 2011 HCPCS information
regarding HCPCS code G0430 replaced with HCPCS code G0434 was added under the
“Coding Guidelines” section. The
effective date of this revision is based on date of service. |
|
04/01/2010 |
1 - Deleted previous instructions regarding
the billing of qualitative drug screening.
Added information related to procedure codes 80100, G0430 and G0431
and the use of modifier QW. The
effective date of this revision is based on date of service. |
|
01/25/2010 |
Original |
Document formatted: 11/30/2010
(DA/et)