With two new codes proposed for urine drug testing in the coming year
, you might need some help sorting it all out. Get a lowdown on the 2011 codes and a rundown of how current policy meshes with your lab's drug screen test method.
2011 codes close loopholes
CMS provided a sneak peak at new lab test codes for CY 2011. You will need to be familiar with the following two just-in codes for drug testing next year:
801XX
GXXX1
With identical definitions, new code 801XX will replace G0430, which was new in 2010.
Problem: It appears that CMS intends new code GXXX1 to close a loophole in how labs use another code introduced in 2010. What happened in response to G0431 is that many labs switched to manufacturers' drug screen kits that use a single analyte strip or paddle for each drug class -- dipped in a single urine specimen. This allowed labs to code each drug class as a single unit of G0431.
Loophole plugged: By making the unit of service the specimen for GXXX1, labs can only list multiple units if the patient provides multiple urine specimens. The Per specimen' wording should materially prevent labs from billing GXXX1 for each drug class dipstick as they could for G0431.
For more on this and for all the CPT code list and changes, sign up for a CPT coding website. Such a site comes stocked with official descriptors and guidelines for all CPT codes. In fact, onboard such a site, you can even have access to the CPT Assistant to help you in your coding career.