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United Healthcare requiring alternative codes for drug screening

November 05, 2013
Area(s) of Interest: Commercial Payors Payor Issues and Reimbursement 


United Healthcare has recently advised that beginning in the first quarter of 2014, it will no longer reimburse CPT codes 80100, 80101 or 80104 for qualitative drug screening. In alignment with the Centers for Medicare & Medicaid Services (CMS), United will require the use of HCPCS codes G0431 and G0434 to report drug screening tests. CMA has asked United to clarify the specific effective date of this change. For more information from CMS on reporting these codes, please see Medicare Learning Network article SE1105 at www.cms.gov. For additional information regarding laboratory services from United, visit the Laboratory Services Policy located on UnitedHealthcareOnline.com.

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