I have a new client who has been billing the following for Presumptive Drug Class Screening (urine). The Laboratory Requisition indicates Drug Screen and Full Confirmation for a Comprehensive Test Panel.

80307 – Drug tests, presumptive, any number of drug classes…by instrument chemistry analyzers, includes sample validation when performed per date of service
G0483 – Drug test(s) definitive, utilizing drug identification methods able to identify individual drugs ….including metabolite(s) if performed
82542 – Column chromatography, includes mass spectrometry if performed, non drug analyte(s) not elsewhere classified, qualitative or quantitative, each specimen.
82570 – Creatinine – other source
83986 – ph, Body fluid
83789 X2 – Mass spec and tandem mass spect…non-drug analyte(s), not elsewhere specified, qualitative or quantitative, each specimen
84311 X2 – Spectrophotometry, analyte, not elsewhere specified.

Research to date shows proper billing for what is documented on the report as 80307 and G0483. Codes 82570 and 83986 would appear to be included under the "sample validation" umbrella and not separately billable.
The questions I have are:

1. Is a specific order required to bill 83789, 84311 and 82542?
2. What additional documentation would need to be demonstrated to consider these codes billable? What they are telling me is that they use this when testing for non-drug analytes such as bath salts or glue, for example. However, on their current reporting form, none of these appear as detected or not detected, just the overall drug classifications.

All assistance is greatly appreciated.

Susan Miedzianowski, CPC