Thursday, December 16, 2010

Qualitative Drug Testing - CPT 80100, 80101 with QW modifier

CMS Guidance on Qualitative Drug Testing March 25, 2010

On March 19, the Centers for Medicare and Medicaid Services (CMS) issued Transmittal
653, Change Request 6852, providing special instructions for billing Qualitative drug
tests using the following specific HCPCS codes:

80100 – Drug screen, qualitative; multiple drug classes chromatographic method, each
procedure

This CPT code remains unchanged and is to be used to report all multiple drug class
assays employing chromatographic methods. It can be reported once for each procedure
(i.e. unique combination of stationary and mobile phase) employed.

Medicare reimbursement will continue to be $20.83.

80101 – Drug screen, qualitative; single drug class method (e.g., immunoassay, enzyme
assay), each drug class

This CPT code will no longer be covered by Medicare after April 1, 2010, but will remain
available for use by non-government payers.

80101 QW – Drug screen, qualitative; single drug class method (e.g., immunoassay,
enzyme assay), each drug class, CLIA waived test.

This code will be deleted from the Medicare Laboratory Fee Schedule effective April 1,
2010.

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