How To Use CPT Code 0227U

CPT 0227U describes a proprietary laboratory analysis (PLA) code for a specific urine drug assay. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0227U.

1. What is CPT Code 0227U?

CPT 0227U is a proprietary laboratory analysis (PLA) code that represents a specific urine drug assay. This test utilizes liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM) to detect and identify 30 or more drugs or metabolites in a urine sample. It includes a detailed drug or metabolite description and also incorporates sample validation to ensure accurate results.

2. Official Description

The official description of CPT code 0227U is: ‘Drug assay, presumptive, 30 or more drugs or metabolites, urine, liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM), with drug or metabolite description, includes sample validation.’

3. Procedure

1. The laboratory analyst receives a urine specimen for analysis.
2. The urine specimen undergoes liquid chromatography with tandem mass spectrometry (LC-MS/MS) using multiple reaction monitoring (MRM) to separate and identify the drugs or metabolites present.
3. The test specifically targets 30 or more drugs or metabolites, providing a comprehensive screen of the urine sample.
4. The laboratory analyst also performs sample validation, which may include assessing creatinine, specific gravity, and pH levels to ensure the integrity of the specimen.
5. The results of the drug assay, including the identified drugs or metabolites, are reported to the ordering clinician.

4. Qualifying circumstances

CPT code 0227U is appropriate for patients who require a comprehensive urine drug assay to detect and identify 30 or more drugs or metabolites. This test is commonly used in pain management treatment and for patients with substance use disorder (SUD). It is important to note that CPT 0227U is a proprietary laboratory analysis (PLA) code, specific to the Comprehensive Screen from Aspenti Health.

5. When to use CPT code 0227U

CPT code 0227U should be used when ordering the specific urine drug assay provided by Aspenti Health. It is important to ensure that the test being performed aligns with the proprietary code and that the laboratory conducting the analysis is authorized to use this code. It is recommended to check with the appropriate payer regarding coverage and reimbursement policies for CPT 0227U.

6. Documentation requirements

To support a claim for CPT code 0227U, documentation should include:

• Order for the urine drug assay
• Date of service
• Results of the drug assay, including the identified drugs or metabolites
• Any additional information relevant to the test, such as specimen validation results

7. Billing guidelines

When billing for CPT code 0227U, ensure that the test is performed by Aspenti Health for the Comprehensive Screen. It is important to report one unit of this code for a single specimen analyzed on a single date of service. Some payers may also separately reimburse for specimen collection, so it is advisable to verify with the appropriate payer.

8. Historical information

CPT code 0227U was added to the Current Procedural Terminology system on January 1, 2021. As a relatively new code, there have been no updates or changes since its addition.

9. Examples

1. A clinician orders CPT code 0227U for a patient undergoing pain management treatment to monitor their medication adherence and detect any potential drug interactions.
2. A patient with substance use disorder (SUD) undergoes CPT code 0227U to assess their drug usage and aid in their treatment and recovery process.
3. A healthcare provider orders CPT code 0227U for a comprehensive urine drug assay as part of a pre-employment screening process for a safety-sensitive position.
4. A clinician utilizes CPT code 0227U to monitor a patient’s compliance with their prescribed medications and ensure appropriate dosage levels.
5. A patient with a history of substance abuse undergoes CPT code 0227U to assess their progress in recovery and identify any potential relapse.
6. A pain management specialist orders CPT code 0227U to monitor a patient’s opioid usage and adjust their treatment plan accordingly.
7. A clinician utilizes CPT code 0227U to assess a patient’s drug usage during a rehabilitation program and guide their personalized treatment approach.
8. A healthcare provider orders CPT code 0227U for a patient with chronic pain to evaluate the effectiveness of their current medication regimen.
9. A clinician utilizes CPT code 0227U to monitor a patient’s compliance with their substance abuse treatment program and ensure their progress towards recovery.
10. A patient undergoing medication-assisted treatment for opioid use disorder undergoes CPT code 0227U to assess their adherence to the prescribed medications.