How To Use CPT Code 80362

CPT code 80362 describes the measurement or detection of one or two opioids and opiate analogs in a patient specimen. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 80362?

CPT 80362 can be used to measure or detect the presence of one or two opioids and opiate analogs in a patient specimen. This code is used when a lab analyst performs a test to determine the amount or presence of these substances in a specimen, such as urine or blood. The test may utilize methodologies like gas chromatography or mass spectrometry to separate and analyze the analytes in the specimen.

2. Official Description

The official description of CPT code 80362 is: ‘Opioids and opiate analogs; 1 or 2.’

3. Procedure

1. The lab analyst collects a patient specimen, such as urine or blood.
2. The specimen is tested using methodologies like gas chromatography or mass spectrometry.
3. The test separates and analyzes the opioids and opiate analogs present in the specimen.
4. The lab analyst quantitates the analytes, determining the exact amount of the substances, or provides a qualitative result indicating whether the specimen is positive or negative for the analytes.
5. The test may be quantitative, qualitative, or a combination of both.

4. Qualifying circumstances

CPT 80362 is used when a clinician orders a test to measure or detect the presence of one or two opioids and opiate analogs in a patient specimen. This test is not limited to a specific condition and may be ordered to diagnose an overdose or assess patient compliance with a prescribed regimen.

5. When to use CPT code 80362

CPT code 80362 should be used when a lab analyst performs a test to measure or detect one or two opioids and opiate analogs in a patient specimen. This code is appropriate when the test is specific to these substances and does not include testing for other opioids or a larger number of opioids and opiate analogs.

6. Documentation requirements

To support a claim for CPT 80362, the documentation should include:

• Reason for ordering the test, such as suspected overdose or compliance assessment
• Type of specimen collected
• Methodology used for testing, such as gas chromatography or mass spectrometry
• Quantitative or qualitative result of the test
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 80362, ensure that the test is specific to one or two opioids and opiate analogs. If the test includes more opioids or opiate analogs, different codes should be used. It is important to follow payer-specific guidelines regarding billing for specimen collection, which may require a separate code. Avoid reporting CPT 80362 with other codes unless necessary.

8. Historical information

CPT 80362 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst measures the amount of oxycodone and hydrocodone in a patient’s urine specimen using gas chromatography.
2. A clinician orders a test to detect the presence of morphine and codeine in a patient’s blood specimen, and the lab analyst performs the test using mass spectrometry.
3. A patient presents with symptoms of opioid overdose, and the lab analyst tests their urine specimen for the presence of fentanyl and tramadol.
4. A clinician suspects non-compliance with a prescribed opioid regimen and orders a test to measure the amount of oxymorphone and hydromorphone in a patient’s urine specimen.
5. A lab analyst performs a test to detect the presence of heroin and methadone in a patient’s blood specimen, as part of a forensic investigation.