How To Use HCPCS Code G0479

HCPCS code G0479 describes drug test(s) that are presumptive and can be performed using any number of drug classes and any number of devices or procedures by instrumented chemistry analyzers utilizing various techniques such as immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, and gc mass spectrometry. This code includes sample validation when performed, per date of service.

1. What is HCPCS G0479?

HCPCS code G0479 is used to identify drug test(s) that are presumptive in nature. These tests can be conducted for any number of drug classes and can utilize various devices or procedures by instrumented chemistry analyzers. The code encompasses a wide range of techniques such as immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, and gc mass spectrometry. When this code is used, it indicates that the drug test includes sample validation when performed, per date of service.

2. Official Description

The official description of HCPCS code G0479 is “Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, gc mass spectrometry), includes sample validation when performed, per date of service.” The short description for this code is “Drug test presump not opt.”

3. Procedure

1. The provider begins the drug test by collecting a sample from the patient, which can be urine, blood, saliva, or other appropriate specimen.
2. The collected sample is then processed using an instrumented chemistry analyzer.
3. The analyzer utilizes various techniques such as immunoassay, enzyme assay, tof, maldi, ldtd, desi, dart, ghpc, and gc mass spectrometry to detect the presence of drugs in the sample.
4. If the test results indicate the presence of drugs, the provider validates the sample to ensure accuracy.
5. The drug test is performed per date of service, which means it is specific to a particular date on which the test was conducted.

4. When to use HCPCS code G0479

HCPCS code G0479 should be used when conducting drug tests that are presumptive in nature. These tests can be performed for any number of drug classes and can utilize various devices or procedures by instrumented chemistry analyzers. It is important to use this code when the drug test includes sample validation and is specific to a particular date of service.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0479, healthcare providers need to ensure proper documentation of the drug test procedure, including the type of sample collected, the instrumented chemistry analyzer used, and the specific techniques employed. It is also important to document the results of the test and any sample validation performed. Providers should follow the billing guidelines set forth by their respective payers and ensure accurate and complete documentation to support the claim.

6. Historical Information and Code Maintenance

HCPCS code G0479 was terminated on December 31, 2016. It is no longer in use and should not be billed for services rendered after this date. The code was added to the Healthcare Common Procedure Coding System on January 01, 2016. It has a coverage code of C, which indicates that carrier judgment is used to determine coverage. The action code for this code is N, which means no maintenance is required. The code is priced subject to a national limitation amount, indicated by the pricing indicator code 21. The multiple pricing indicator code for this code is A, which means it is not applicable as HCPCS is priced under one methodology. The type of service code for HCPCS code G0479 is 5, which represents diagnostic laboratory services. The anesthesia base unit quantity for this code is 0, indicating that it is not applicable for anesthesia services.

7. Medicare and Insurance Coverage

Medicare coverage for HCPCS code G0479 may vary depending on the specific circumstances and guidelines set forth by the Centers for Medicare and Medicaid Services (CMS). It is important for healthcare providers to verify coverage and reimbursement policies with Medicare and other insurance carriers. The pricing indicator code 21 indicates that the price for this code is subject to a national limitation amount. The multiple pricing indicator code A signifies that the code is not applicable as HCPCS is priced under one methodology. Providers should consult the Medicare Physician Fee Schedule and other relevant resources for accurate pricing and coverage information.

8. Examples

Here are five examples of when HCPCS code G0479 should be billed:

1. A patient undergoes a drug test for multiple drug classes using an instrumented chemistry analyzer with immunoassay technique. The test includes sample validation and is performed on a specific date of service.
2. A healthcare provider conducts a presumptive drug test utilizing enzyme assay technique for a single drug class. The test includes sample validation and is specific to a particular date of service.
3. Drug tests are performed on multiple patients using various devices and procedures by instrumented chemistry analyzers. The tests cover different drug classes and include sample validation. Each test is billed separately based on the date of service.
4. A laboratory conducts drug tests on urine samples collected from individuals suspected of drug use. The tests utilize tof, maldi, ldtd, desi, dart, ghpc, and gc mass spectrometry techniques. Sample validation is performed for each test, and the billing is done per date of service.
5. A healthcare facility performs drug tests on blood samples using an instrumented chemistry analyzer with immunoassay technique. The tests cover multiple drug classes, and sample validation is conducted for each test. Billing is done based on the specific date of service for each test.