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Tag Archives: fluid

Oral Fluid Drug Screen Testing

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We are a CLIA approved lab that does in-house urine drug screens using cpt code 80305 with modifier QW. Recently our clinic started offering Vivitrol injections and part of the patients therapy is to be drug screened. It was decided to do the drug screens using oral fluid due to the swab being capable of detecting the presence of alcohol along with 13 other drug classes through optical observation. Some of the medical staff are concerned that this method isn’t CLIA approved and another would like to test for both the urine and the oral fluid; so can anyone tell me if there is a specific brand of swab we need to use or it doesn’t matter as long as it is coded once per day with 80305 – QW. Any input would be appreciated.

Thank you,
Lisa

Medical Billing and Coding Forum

Drug Testing for Oral Fluid instead of Urine

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I’m with an SIU and we are consistently seeing labs that are billing for Oral Fluid Drug Testing using the G0480-G0483 series codes. Does anyone have a better code recommended for billing using Oral Fluid drug testing in both Pain Management and Substance Abuse?

We usually follow Medicare Guidelines and our Policy is based on the LCD for UDT’s and we are having difficulty finding any guidance surrounding Oral Fluids as LCD L36393 only mentions Oral Fluid in a very general sense, everything is aimed directly at urine. There are no specific CPT or HCPCs codes mentioned as appropriate to be used for Oral Fluid testing or guidance.

We did locate 0011U-Prescription drug monitoring, evaluation of drugs present by LC-MS/MS, using oral fluid, reported as a comparison to an estimated steady-state range, per date of service including all drug compounds and metabolites. This is listed as a PLA code but I’m not entirely sure what would be required to verify that the lab performing this service is properly set up to perform this service.

Any help would be greatly appreciated.

Medical Billing and Coding Forum

Amniotic Fluid Injections

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I was wondering if anyone is doing injections with amniotic fluid (allograft) in an Ambulatory Surgery Center. I know Medicare will not pay an additional amount for the amniotic fluid, but I want to find out if other carriers pay separately for it. Also, I’d like to know what HCPCS II code is being used and what revenue code is being used. Thanks

Medical Billing and Coding Forum

OB Ultrasound code 76819 for an Amniotic Fluid Index only?

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Hi Everyone,

I am a CPC-A extern working at an ultrasound center that performs ultrasounds mainly on pregnant patients.

Here is the discussion that has come up recently (and kind of ongoing) :

Can code 76819, Fetal biophysical profile, without non-stress testing, be used if only an Amniotic Fluid Index was done, and not the biophysical profile, as well as a follow-up ultrasound, code 76816? I pointed out to the technologist that in the CPC book, it says under code 76819 that "for amniotic fluid index without non-stress test, use 76815". But he says that you can’t code 76815, a limited, with a more complete code of 76816. So he uses 76819 instead to represent amniotic fluid index only, along with 76816.

Does that statement under code 76819 mean that when one only does an amniotic fluid index and nothing else, you can use 76815?

Any input on this would be greatly appreciated!

Thank you!

Maureen Baetz, CPC-A
Batavia, IL

Medical Billing and Coding Forum

NuCel amniotic fluid injection

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Hi all,

Looking for an administration code for this. I have an surgeon who has used this on 3 separate occasions.
1. Proximal humerus fracture repaired by ORIF and a mix of cancellous chips and NuCel put into the bone void (NOT INJECTED) after the orif was completed.
2. Two patients that had meniscectomy and then were injected with NuCel at the completion the surgery.

We will not billing the supply as the hospital purchased the NuCel, but I was wondering if there is a injection code/administration code for this…or is it consider part of the surgery?

Any advise is appreciated.

Thank you

Medical Billing and Coding Forum

Sclerotherapy of Fluid Collection Coding

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Code 49185 Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed describes sclerotherapy of a fluid collection, such as a lymphocele,
AAPC Knowledge Center