Drug screen testing changes effective 1/1/2014 (Nov. 23, 2013)

Effective 1/1/2014, Wellmark will no longer accept codes 80101 & 80104 for drug screening. Wellmark now follows CMS guidelines, which allow the following two test codes to be reported for drug screen testing:

G0434 (Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter) will be used to report very simple testing methods, such as dipsticks, cups, cassettes, and cards that are interpreted visually, with the assistance of a scanner, or are read utilizing a moderately complex reader device outside the instrumented laboratory setting (i.e., non-instrumented devices). Only one unit of service for code G0434 can be billed per patient encounter, regardless of the number of drug classes tested and irrespective of the use or presence of the QW modifier on claim lines.

G0431 (Drug screen, qualitative; multiple drug classes by high complexity test method — e.g., immunoassay, enzyme assay — per patient encounter) will be used to report more complex testing methods, such as multi-channel chemistry analyzers, where a more complex instrumented device is required to perform some or all of the screening tests for the patient. Code G0431 may only be reported once per patient encounter.