Independence Blue Cross
Definitive Drug Testing
Antidepressants to a combined maximum of up to 15 units of tests per calendar year. (CPT codes: 80332, 80333, 80334, 80335, 80336, 80337, 80338) Antiepileptics to a combined maximum of up to 15 units of tests per calendar year. (CPT codes: 80339, 80340, 80341, 80355, 80366, 80156, 80157, 80164, 80165, 80168, 80171, 80175, 80177, 80183, 80184, 80185, 80186, 80188, 80199, 80201, 80203) Antipsychotics to a combined maximum of up to 15 units of tests per calendar year. (CPT codes: 80342, 80343, 80344, 80159, 80173, 80178)
Medical Mutual of Ohio
Presumptive Drug Testing
Qualitative drug screening of more than 12 units within 365 days per member.
Definitive Drug Testing
Qualitative drug testing when billed with any combination of more than twenty (20) units within 365 days per Member.
Medicare
Presumptive and Definitive Drug Testing
The frequency limit for each (presumptive and definitive) is 12 times per 365 days, from the time of service is first rendered.
MOLINA NY
Definitive Drug Testing
Allowed Frequency for G0480 is 6 time per calendar year.
Medicaid of New York
Presumptive and Definitive Drug Testing
Eff 4/1/17 for DOS 1/1/17 80307 cannot be billed with G0480. G0480 can only be billed 6 times in a calendar year. The G0480 code is the only allowed Definitive code per NY Medicaid UDT policy.
Neighborhood HP/MassHealth
Presumptive Drug Testing
Only allows for one (1) presumptive tester per day.
Definitive Drug Testing
Frequency limit is 20 for both presumptive and definitive drug testing in a calendar year.
Medicaid of North Carolina
Presumptive and Definitive Drug Testing
Effective Nov. 1, 2017, N.C. Medicaid and N.C. Health Choice (NCHC) shall cover presumptive testing up to 24 times and definitive testing up to 24 times per state fiscal year (July 1-June 30).
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For questions call billing customer service at 844.345.1821 or email patient.billing @ DRUGSCAN.com
For questions call billing customer service at 844.345.1821 or email patient.billing @ DRUGSCAN.com
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