Presumptive Eligibility (PE) Program for Pregnant Women: New Lab Benefits

Effective for dates of service on or after September 1, 2010, HCPCS Level II laboratory procedure codes G0430 (drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure) and G0431 (drug screen, qualitative; single drug class method [eg., immunoassay, enzyme assay], each drug class) will become benefits for the PE program for pregnant women.

Both codes are split-billed and must be billed with modifier 26, TC or ZS.

Source: General Medicine | August 2010 | Bulletin 434