Controlled Substance Monitoring and Drugs of Abuse Coding and Billing Guidelines

Palmetto GBA has released coding and billing guidelines pertaining to the new 2016 Drug Testing codes. They have identified the HCPCS codes to use when billing Presumptive Urine Drug Testing (UDT) or Definitive (Qualitative or Quantitative) UDT Testing. Providers may ONLY perform and report one of the following three types of presumptive UDT available per patient encounter (G0477-G0479). Based on the number of drug classes indicated for the patient’s needs, providers may ONLY perform and report one of the following four Definitive UDT services per patient encounter (G0480-G0483).

MAC JM for North Carolina, South Carolina, Virginia and West Virginia