Billing Beat

Reminder for Urine Drug Testing Policy

July 28, 2017

Recently National Government Services has seen an increase of denials for drug testing claims, specifically CPT code 80307 and HCPCS code G0480. CPT code 80307 is a presumptive testing code for screening of various drugs and HCPCS code G0480 is performed to identify specific drug amounts once positive results are found on the screening. Both codes are listed on the Medically Unlikely Edit table on the CMS website and have an MUE Adjudication Indicator (MAI) of “2”.  MUEs with a MAI of “2” are absolute date of service edits. These are “per day edits based on policy.” This MAI designation was obtained because the units of service (UOS) on the same date of service (DOS) in excess of the MUE value would be considered impossible because it was contrary to statute, regulation, or sub regulatory guidance. These noted services have an MUE value of “1”, this represents the maximum UOS that a practitioner would report under most circumstances for a single beneficiary on a single date of service. For additional guidelines, please review the LCD for Urine Drug Testing (L36037) .

Source: https://www.ngsmedicare.com/ngs/portal/ngsmedicare/newngs/home-lob/news-alerts/news-articles/news-detail/reminder for urine drug testing policy lcd l36037/!ut/p/a1/zVJNU8MgEP0reOiRgYTY5EpTrdpPdbQllw4lNNJJSIZQq_56yVi_bas3GS77dnn72LcoQTOUaH6vMm5VqXnexEl7HtDzE8-LcX8cnWFM-10a0FGPRDcemqIEJYNxjFhcai2FVWJtG2y1NqpOlWiIELv4EIF-k9dZPRh3EJtwY0HnDflOJLSt7B1iLl1IR8GNFKW2UlstNy38AX6J5aaGXKeQ59LY-hUwji-XLty-bWEjC6VTacCyNMDJ0xKkZp0BK2urdAaqMlfiEeQiBTlpYxI2YiqhUsQWnEfEX7bhgh9zGAQ4hJEfSeh74UKkYUr4IniZy_sHZ4i5SeIdh-JfDfpTCRlHmAannW73ckJ6HX9bsKcFcxrCnU08D103HNN4OL-8Obly1d_8YHttZV9MZT9Zyr7Y_oeRHtBP_rv-i0MmuyXxzTAeZo6W2zuo9LJEs79v6tQpK2_1Q2-DqqKIyPbCGV4dVxmlkxHkjNLu07KYRtnRMwYQptI!/dl5/d5/L2dBISEvZ0FBIS9nQSEh/?LOB=Part%20B&LOC=Connecticut&ngsLOB=Part%20B&ngsLOC=Connecticut&jurisdiction=Jurisdiction%20K

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