I have a provider that was denied by Cigna when trying to add G0477 (urine drug screen) to his contract but they responded and said they are adding G0478. The only difference between the two tests is that G0478 requires the use of a scanner in addition to optical viewing of the test strip to read the results. I have looked to see if G0478 requires a QW modifier and is CLIA waived but see that it is not on the CMS list. I know that initially G0477 was left off the list and later added to be backdated to January 1, 2016 so I’m wondering if anyone has heard if the same will be happening with G0478?

The provider is willing to purchase the scanner so he can bill G0478 but if it is not going to be paid then there’s really no point in spending that money. Please help with any information you have available.

Thank you in advance!!