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What makes a good CPC Practice Exam? Questions and Answers with Full Rationale
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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes)
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2016 Deleted Lab Codes List
82486 Chromatography, qualitative; column (eg, gas liquid or HPLC, analyte not elsewhere specified)
82486 has been deleted. For a qualitative column chromatography procedure, use the appropriate specific analyte code, if available, or 82542
82487 Chromatography, qualitative; paper, 1-dimensional, analyte not elsewhere specified
82488 Chromatography, qualitative; paper, 2-dimensional, analyte not elsewhere specified
82487, 82488 have been deleted. For a paper chromatography procedure, use the appropriate specific analyte code, if available, or 84999
82489 Chromatography, qualitative; thin layer, analyte not elsewhere specified
82489 has been deleted. For a thin layer chromatography procedure, use the appropriate specific analyte code, if available, or 84999
82491 Chromatography, qualitative; column (eg, gas liquid or HPLC); single analyte not elsewhere specified, single stationary and mobile phase
82491 has been deleted. For a quantitative column chromatography procedure, use the appropriate specific analyte code, if available, or 82542
82492 Chromatography, qualitative; column (eg, gas liquid or HPLC); multiple analytes, single stationary and mobile phase
82492 has been deleted. For a quantitative column chromatography procedure that detects more than one analyte, use a single specific code that represents all of the analytes, if available, or one unit of 82542 for all of the analytes.
82541 Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), non-drug analyte not elsewhere specified; qualitative, single stationary and mobile phase
82541 has been deleted. For a quantitative chromatography procedure with mass spectrometry that only detects a single specific analyte, use the appropriate specific analyte code, if applicable, or 82542
82543 stable isotope dilution, single analyte, quantitative, single stationary and mobile phase.
82543 has been deleted. For a quantitative chromatography procedure with mass spectrometry that only detects a single specific analyte, use the appropriate specific analyte code, if applicable, or 82542
82544 stable isotope dilution, multiple analytes, quantitative, single stationary and mobile phase. 82544 has been deleted. For a quantitative chromatography procedure with mass spectrometry that detects more than one analyte, use a single specific code that represents all of the analytes, if applicable, or one unit of 82542 for all of the analytes
83788 Mass spectrometry and tandem mass spectrometry (MS, MS/MS), analyte not elsewhere specified; qualitative, each specimen.
83788 has been deleted. For a qualitative mass spectrometry or tandem mass spectrometry procedure, use the specific analyte code, if available, or 83789
88347 Immunofluorescent study, each antibody; indirect method. 88347 has been deleted. To report, see 88346, 88350
G0431 Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter
G0434 Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter
G0464 Colorectal cancer screening; stool-based DNA and fecal occult hemoglobin (e.g., KRAS, NDRG4 and BMP3). This code has been replaced with code 81528: Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result.
G6030 Amitriptyline
G6031 Benzodiazepines
G6032 Desipramine
G6034 Doxepin
G6035 Gold
G6036 Imipramine
G6037 Nortriptyline
G6038 Salicylate
G6039 Acetaminophen
G6040 Alcohol (ethanol); any specimen except breath
G6041 Alkaloids, urine, quantitative
G6042 Amphetamine or methamphetamine
G6043 Barbiturates, not elsewhere specified
G6044 Cocaine or metabolite
G6045 Dihydrocodeinone
G6046 Dihydromorphinone
G6047 Dihydrotestosterone
G6048 Dimethadione
Coding Ahead
Current coding for testing for drugs of abuse relies on a structure of “screening” (known as “presumptive” testing) followed by “confirmation” to confirm the results of the screening tests and quantitative or “definitive” testing that identifies the specific drug and quantity in the patient.
Presumptive Testing
A test used to detect the presence of a drug in a urine sample. The test is performed by a provider with Certification of Waiver or a Medical Test Site Accredited License. Findings are reported qualitatively as either positive or negative.
Definitive Testing
Definitive tests are performed in a laboratory or by a provider with Certificate of Registration, Compliance of Accreditation or Medical Test Site Categorized License or Accredited License. The tests are able to quantify the amount of drug or metabolite present in the urine sample. definitive tests can be used to confirm the presence of a specific drug identified by a screening test and can identify drugs that cannot be isolated by currently available presumptive testing. Results are reported as specific levels of substances detected in the urine sample.
Effective for the dates of services from January 01, 2016 CMS implemented the following changes for drug testing;
1. Deleted the HCPCS codes G0431, G0434 and G6030 through G6058
2. Continue to not recognize the AMA CPT codes 80300 – 80377
3. For presumptive testing, created three G codes:
G0477 – Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service
G0478 – Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) read by instrument-assisted direct optical observation (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service
G0479 – Drug test(s), presumptive, any number of drug classes; any number of devices or procedures by instrumented chemistry analyzers utilizing immunoassay, enzyme assay, TOF, MALDI, LDTD, DESI, DART, GHPC, GC mass spectrometry), includes sample validation when performed, per date of service
4. For definitive drug testing, created four tiered G codes:
G0480 – Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays (e.g., IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (e.g., alcohol dehydrogenase)); qualitative or quantitative, all sources(s), includes specimen validity testing, per day, 1-7 drug class(es), including metabolite(s) if performed
G0481 – Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays (e.g., IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (e.g., alcohol dehydrogenase)); qualitative or quantitative, all sources(s), includes specimen validity testing, per day, 8-14 drug class(es), including metabolite(s) if performed
G0482 – Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays (e.g., IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (e.g., alcohol dehydrogenase)); qualitative or quantitative, all sources(s), includes specimen validity testing, per day, 15-21 drug class(es), including metabolite(s) if performed
G0483 – Drug test(s), definitive, utilizing drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to GC/MS (any type, single or tandem) and LC/MS (any type, single or tandem and excluding immunoassays (e.g., IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (e.g., alcohol dehydrogenase)); qualitative or quantitative, all sources(s), includes specimen validity testing, per day, 22 or more drug class(es), including metabolite(s) if performed
Guidelines to report Presumptive Testing;
Presumptive codes G0477 – G0479 is eligible for reimbursement when testing is performed in an office, laboratory or facility setting. These codes are not eligible for reimbursement for chemical dependency facilities. Reimbursement for procedure codes G0477 – G0479 is limited to one unit per day. Only one of the three codes may be billed per day.
Guidelines to report Definitive Testing;
The definitive tests must be both more sensitive and specific than the initial screen. Reimbursement for procedure codes G0480 – G0483 is limited to one unit per day. The unit used to determine the appropriate code to bill is “drug class.” The number of drug classes tested determines the appropriate code to use. Each drug class may only be used once per day. Only one of the four codes may be billed per day.
Modifiers
Modifiers 59, XE, XP, XS, XU and 91 should not be reported with procedure codes G0477-G0479 and G0480-G0483 to bypass the edits.
Reference:
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ClinicalLabFeeSched/Downloads/CY2016-CLFS-Codes-Final-Determinations.pdf
Coding Ahead