Hcpcs 2010: Two New Codes For Medicare Beneficiary Drug Screens

By Author: Julia Rose
Total Articles: 89
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HCPCS 2010 brings along two new codes for Medicare beneficiary drug screens alright, but do you know how to use them?


As soon as CMS rolled out the codes - G0431 and G0430, the agency instituted some restrictions. Here are three tips from the experts to help you round up all facts you need to pick the right code:


The first thing to remember is that payer determines code choice. If you're reporting drug screen testing for non-Medicare payers, your code choices will remain the same as they have been for years.


Secondly, you shouldn't ignore certification. Until April 1, labs should choose G0431 or 80101-QW based on whether the lab operates under a Clinical Laboratory Improvement Amendments (CLIA) certificate of waiver. This is because CMS is delaying full G0431 implementation until April 1. Till that time, the agency instructs labs to report qualitative drug screening tests for a single class of drugs, regardless of testing method.


Thirdly, you should allow Lab method to lead you. It's the crucial distinction between 80100 and G0430. But the hitch ...
... with 80100 is that it describes only chromatographic testing for the presence of drugs, which leaves certain laboratories unable to bill accurately when performing a qualitative multiple drug class screen that doesn't use chromatography. But solution's at hand as CMS implements G0430 to remove limitation of method (chromatographic) when the lab uses a non-chromatographic method for a qualitative multiple drug class screen.


For more expert tips on pathology coding and ways to wield the two new HCPCS codes for Medicare beneficiary drug screens, turn to a pathology service coding handbook or better still tune in to audio recordings of medical coding conferences in CDs and MP3s for the real action!


Gain knowledge about medical coding by attending proper medical billing seminars along with premier coding experts, CDs, tapes and transcripts of coding training information by specialty.