Reimbursement policy updates: Drug Screening

Effective 1/1/2013, Empire will no longer reimburse codes 80100, 80101, and 80104. Qualitative drug screening will only be eligible for reimbursement under codes G0431 and G0434. Both codes G0431 and G0434 will be eligible for 1 unit of reimbursement per date of service. Use of code G0431 (direct replacement of 80101) is limited to only high complexity testing, and documentation of FDA approved complexity level for instrumented equipment utilized, and/or CLIA Certificate of Registration, Compliance, or Accreditation as a high complexity lab, may be requested as a condition for reimbursement.