Changes in Billing for Drugs of Abuse Testing Codes

January 2016

Effective for dates of service in 2016, WSI adopted new CMS standards regarding billing for drugs of abuse. 

WSI follows current HCPCs codes for 2016 and requires providers to bill the new “G” HCPC codes (G0477-G0483) when billing for drug testing. A provider may bill one presumptive code per day (G0477-G0479) for a screening. For screenings that return a positive result, a provider may bill the corresponding definitive code (G0480-G0483) for confirmation of the results.

WSI will continue not recognizing the AMA CPT codes 80300-80377.

For additional clarification, please refer to CMS’s Clinical Laboratory Fee Schedule Final Determinations.

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