Drug CPT Coding

Drug Screening: The insurer will pay for drug screening conducted in the office setting by a laboratory with a Clinical Laboratory Improvement Amendment certificate of waiver and confirmation testing performed at a laboratory not requiring a CLIA certificate of waiver. 

80100, Drug screen, qualitative; multiple drug classes chromatographic method, each procedure. 80102, Drug confirmation, each procedure. G0431, Drug screen, qualitative; single drug class method , each drug class. G0434, Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter. 

80100 and 80102 are only payable to laboratories that do not require a CLIA certificate of waiver. G0431 is limited to one unit per day per patient encounter for laboratories with a CLIA certificate of waiver. Laboratories that do not require a CLIA certificate of waiver may bill more than one unit per day per patient encounter. G0434 is limited to one unit per day per patient encounter regardless of the CLIA status of the laboratory.  

Codes that are not covered
      80101       80104 

80101* – Drug Screen, qualitative; single drug class method  - add QW modifier if billing Medicare/Medicaid