(2023) CPT Codes & Billing Guidelines For Drug Assays

The CPT codes for drug assays and the billing guidelines are below.

List With CPT Codes For Drug Assays

CPT 80320 Description: Alcohols

CPT 80321 Description: Alcohol biomarkers; 1 or 2 

CPT 80322 Description: Alcohol biomarkers; 3 or more

CPT 80323 Description: Alkaloids, not otherwise specified

CPT 80324 Description: Amphetamines; 1 or 2

CPT 80325 Description: Amphetamines; 3 or 4 

CPT 80326 Description: Amphetamines; 5 or more

CPT 80327 Description: Anabolic steroids; 1 or 2

CPT 80328 Description: Anabolic steroids; 3 or more

CPT 80329 Description: Anagesics, non-opiod; 1 or 2

CPT 80330 Description: Analgesics, non-opiod; 3-5

CPT 80331 Description: Analgesics, non-opiod; 6 or more

CPT 80332 Description: Antidepressants, serotonergic class; 1 or 2

CPT 80333 Description: Antidepressants, serotonergic class; 3-5

CPT 80334 Description: Antidepressants, serotonergic class; 6 or more

CPT 80335 Description: Antidepressants, tricyclic and other cyclical; 1 or 2

CPT 80336 Description: Antidepressants, tricyclic and other cyclical; 3-5

CPT 80337 Description: Antidepressants, tricyclic and other cyclical; 6 or more

CPT 80338 Description: Antidepressants, not otherwise classified

CPT 80339 Description: Antiepileptics, not otherwise specified; 1-3

CPT 80340 Description: Antiepileptics, not otherwise specified; 4-6

CPT 80341 Description: Antiepileptics, not otherwise specified; 7 or more

CPT 80342 Description: Antipsychotics, not otherwise specified; 1-3

CPT 80343 Description: Antipsychotics, not otherwise specified; 4-6

CPT 80344 Description: Antipsychotics, not otherwise specified; 7 or more

CPT 80345 Description: Barbiturates

CPT 80346 Description: Benzodiazepines; 1-12

CPT 80347 Description: Benzodiazepines; 13 or more

CPT 80348 Description: Buprenorphine

CPT 80349 Description: Cannabinoids, natural  

CPT 80350 Description: Cannabinoids, synthetic; 1-3          

CPT 80351 Description: Cannabinoids, synthetic; 4-6

CPT 80352 Description: Cannabinoids, synthetic; 7 or more

CPT 80353 Description: Cocaine

CPT 80354 Description: Fentanyl

CPT 80355 Description: Gabapentin, non-blood

CPT 80356 Description: Heroin metabolite 

CPT 80357 Description: Ketamine and norketamine

CPT 80358 Description: Methadone

CPT 80359 Description: Methylenedioxyamphetamines (MDA, MDEA, MDMA)

CPT 80360 Description: Methyphenidate

CPT 80361 Description: Opiates, 1 or more

CPT 80362 Description: Opiods and opiate analogs; 1 or 2

CPT 80363 Description: Opiods and opiate analogs; 3 or 4

CPT 80364 Description: Opiods and opiate analogs; 5 or more

CPT 80365 Description: Oxycodone

CPT 80366 Description: Pregabalin

CPT 80367 Description: Propoxyphene

CPT 80368 Description: Sedative hypnotics (non-benzodiazepines)

CPT 80369 Description: Skeletal muscle relaxants; 1 o 2

CPT 80370 Description: Skeletal muscle relaxants; 3 or more

CPT 80371 Description: Stimulants, synthetic

CPT 80372 Description: Tapentadol

CPT 80373 Description: Tramadol

CPT 80374 Description: Stereoisomer (enantiomer) analysis, single drug class

CPT 80375 Description: Drug(s) or substance(s), definitive, qualitative or quantitative,not  otherwise specified; 1-3

CPT 80376 Description: Drug(s) or substance(s), definitive, qualitative or quantitative,not  otherwise specified; 4-6

CPT 80377 Description: Drug(s) or substance(s), definitive, qualitative or quantitative,not  otherwise specified; 7 or more

Billing Guidelines For Drug Assays

The Definitive Drug Class methods can identify individual drugs and distinguish between structural isomers but not necessarily stereoisomers, such as gas chromatography with mass spectrometry, liquid chromatography mass spectrometry.

The AMA specifically reminds us that methods such as immunoassay or enzymatic methods are EXCLUDED from being considered definitive drug
testing (i.e., they are presumptive).

When chromatography is used, each combination of stationary and mobile phases will be counted as one procedure.

This drug class testing also allows for qualitative and quantitative or a combination of qualitative and quantitative values. The Definitive Drug Class Listing provides the drug classes, their associated codes, and the drugs included in each class.

Each category of a drug class, including metabolite(s) if performed (except steroisomers), is reported once per date of service. If a metabolite is not listed in the table, the AMA states to report using the code for the parent drug.

Drug class metabolite(s) is not reported separately unless the metabolite(s) is listed as a separate category in the Definitive Drug Classes Listing (e.g., heroin metabolite).

Definitive drug procedures that are not specified for the code range 80320-80373 should be reported using the unlisted definitive procedure codes 80375, 80376, 80377 unless the specific analyte is listed in the Therapeutic Drug Assays section (80150-80203) or Chemistry section (82009-84830) sections.

In other words, you are not to use the unlisted definitive codes if the drug is listed in either of those sections.