The AMA introduced the following pathology/laboratory code changes for 2015.
The three subsections associated with drug procedures are:
•Therapeutic Drug Assay (TDA), and
In the “Drug Assay” section, the two following subsections are the major categories for drug testing:
• Presumptive Drug Class and
• Definitive Drug Class testing
These types of drug testing are commonly done first by presumptive screening method then may be done by a definitive drug identification method as well.
DRUG ASSAYS- PRESUMPTIVE DRUG CLASS SCREENING
CPT Code: 80300
Code Description: Drug screen, any number of drug classes from Drug Class List A; any number of non-TLC devices or procedures, (eg, immunoassay) capable of being read by direct optical observation, including instrumented-assisted when performed (eg, dipsticks, cups, cards, cartridges), per date of service.
Code Description: Drug screen, any number of drug classes from Drug Class List A; single drug class method, by instrumented test systems (eg, discrete multichannel chemistry analyzers utilizing immunoassay or enzyme assay), per date of service.
Code Description: Drug screen, presumptive, single drug class from Drug Class List B, by immunoassay (eg,ELISA) or non-TLC chromatography without mass spectrometry (eg, GC, HPLC), each procedure
CPT Code: 80303
Code Description: Drug screen, any number of drug classes, presumptive, single or multiple drug class method; thin layer chromatography procedures(s) (TLC) (eg, acid, neutral, alkaloid plate), per date of service
CPT Code: 80304
Drug screen, any number of drug classes, presumptive, single or multiple drug class method; not otherwise specified presumptive procedure (eg, TOF, MALDI, LDTD, DESI, DART), each procedure
A major change in this section is the deletion of the Drug Screening services (Codes CPT 80100, CPT 80101, CPT 80102, CPT 80103, and CPT 80104) and the replacement of them with new codes that more clearly define the drug class and the methodologies involved in the testing (CPT 80300, CPT 80301, CPT 80302, CPT 80303, CPT 80304).
A key point for Presumptive Drug testing is that the reported value may be qualitative, semi-quantitative or quantitative depending on the purpose of the testing. AMA specifically states that methods that cannot distinguish between structural isomers (such as morphine and hydromorphone or methamphetamine and phentermine) are considered presumptive. The list of drug classes and the methodology used are considered when coding presumptive procedures.
AMA provides a complete list of drugs categories as “Drug Class A” or “Drug Class B” in the code book, located in the “Presumptive Drug Class Screening” section.