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urine drug screening to Medicare

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lucyspurg:
We recently purchased an analyzer and are doing urine drug screening. We are CLIA certified.  The company from whom we purchased the machine said use code G0431 for MEdicare and suggested a price to bill for the panel. We have been denied for our first claim with "claim lacks information".  Any ideas?

mbloom:
Did you put the CLIA number in box 23?

Marcus2013:
Yes you are correct! We should use CLIA# for the procedure codes G0434, G0431 & 80101, 80104. Otherwise it will get denied for "Claim/service lacks information which is needed for adjudication"

Also remember the following rule:

Multiple Drug class method = We should bill the procedure code 80101-ALTERNATE CODE FOR MEDICARE(G0431 Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter)

Single Drug class method = We should bill the procedure code 80104-ALTERNATE CODE FOR MEDICARE G0434 Drug screen, other than chromatographic; any number of drug classes, by CLIA waived test or moderate complexity test, per patient encounter

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