When services can be administered in various settings, the Company reserves the right to reimburse only those services that are furnished in the most appropriate and cost-effective setting that is appropriate to the member’s medical needs and condition. This decision is based on the member’s current medical condition and any required monitoring or additional services that may coincide with the delivery of this service.
This Medical Policy Bulletin document describes the status of medical technology at the time the document was developed. Since that time, new technology may have emerged or new medical literature may have been published. This Medical Policy Bulletin will be reviewed regularly and be updated as scientific and medical literature becomes available. For more information on how Medical Policy Bulletins are developed, go to the About This Site section of this Medical Policy Web site.
PRESUMPTIVE DRUG CLASS TESTING
80305, 80306, 80307
WHEN PERFORMED IN CONJUNCTION WITH PRESUMPTIVE AND DEFINITIVE DRUG TESTING, THE FOLLOWING PROCEDURE CODES REPRESENT SPECIMEN VALIDITY/ADULTERATION TESTING, AND ARE NOT SEPARATELY REIMBURSED; (THESE CODES ARE NOT REIMBURSED WHEN BILLED IN CONJUNCTION WITH PROCEDURE CODES THAT THE COMPANY DOES NOT ACCEPT)
82542, 82570, 83986, 84311, 84315
0007U, 0011U, 0051U, 0054U, 0082U, 0093U, 0110U, 0116U, 0117U, 0143U, 0144U, 0145U, 0146U, 0147U, 0148U, 0149U, 0150U
THE COMPANY DOES NOT ACCEPT THESE PROCEDURE CODES FOR DEFINITIVE DRUG CLASS TESTING
80320, 80321, 80322, 80323, 80324, 80325, 80326, 80327, 80328, 80329, 80330, 80331, 80345, 80346, 80347, 80348, 80349, 80350, 80351, 80352, 80353, 80354, 80356, 80357, 80358, 80359, 80360, 80361, 80362, 80363, 80364, 80365, 80367, 80368, 80369, 80370, 80371, 80372, 80373, 80375, 80376, 80377, 83992