How To Use CPT Code 80376

CPT 80376 describes the procedure for definitive drug testing, specifically for the analysis of four to six definitive drugs in a patient specimen. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 80376?

CPT 80376 can be used to describe the procedure for definitive drug testing, focusing on the analysis of four to six definitive drugs in a patient specimen. This code is used when a lab analyst performs a test to determine the presence or measure the amount of these specific drugs in the specimen, which can be urine or serum.

2. Official Description

The official description of CPT code 80376 is: ‘Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6.’

3. Procedure

1. The lab analyst receives the patient specimen, which is typically urine or serum.
2. The analyst performs a test to analyze the presence or measure the amount of four to six definitive drugs in the specimen.
3. To analyze the presence of the drugs qualitatively, the analyst compares the specimen’s results to a predetermined value. If the amount exceeds the value, the drug is considered present; if it is below the value, the drug is considered negative.
4. To analyze the presence of the drugs quantitatively, the analyst may use methodologies such as gas or liquid chromatography or mass spectrometry. These methods separate and analyze the analytes in the specimen, allowing for the quantitation of the specific quantity of the drugs present.

4. Qualifying circumstances

CPT 80376 is used when the lab analyst tests a patient specimen for the presence or amount of four to six definitive drugs. This procedure is not limited to testing for a specific condition and can be ordered by clinicians to verify the presence and quantity of drugs within the body.

5. When to use CPT code 80376

CPT code 80376 should be used when the lab analyst performs a definitive drug testing procedure and analyzes a patient specimen for four to six specific drugs. This code is not appropriate for testing one to three drugs or seven or more drugs.

6. Documentation requirements

To support a claim for CPT 80376, the documentation should include:

• Identification of the patient specimen (urine or serum)
• List of the four to six definitive drugs being tested
• Results of the qualitative or quantitative analysis
• Methodology used for the analysis (e.g., gas or liquid chromatography, mass spectrometry)
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 80376, ensure that the lab analyst performs the test for four to six definitive drugs in the patient specimen. If the test involves one to three drugs, use CPT code 80375. For seven or more drugs, use CPT code 80377. It is important to follow the specific guidelines provided by the payer and to use the appropriate modifiers if necessary.

8. Historical information

CPT 80376 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates or changes to the code since its addition.

9. Examples

1. A lab analyst performs a definitive drug testing procedure on a urine specimen, analyzing the presence and amount of four specific drugs.
2. Using gas chromatography, a lab analyst tests a serum specimen for the presence and quantity of six definitive drugs.
3. A patient’s urine specimen is analyzed by a lab analyst using mass spectrometry to determine the presence and amount of five specific drugs.
4. During a definitive drug testing procedure, a lab analyst examines a serum specimen for the presence and quantity of four definitive drugs using liquid chromatography.
5. An analyst performs a qualitative and quantitative analysis on a urine specimen, testing for the presence and amount of six specific drugs.
6. Using mass spectrometry, a lab analyst analyzes a serum specimen for the presence and quantity of five definitive drugs during a definitive drug testing procedure.
7. A patient’s urine specimen is tested by a lab analyst for the presence and amount of four specific drugs using gas chromatography.
8. During a definitive drug testing procedure, a lab analyst examines a serum specimen for the presence and quantity of six definitive drugs using liquid chromatography.
9. An analyst performs a qualitative and quantitative analysis on a urine specimen, testing for the presence and amount of five specific drugs.
10. Using mass spectrometry, a lab analyst analyzes a serum specimen for the presence and quantity of four definitive drugs during a definitive drug testing procedure.