UDS 80305

[Pain Applicant1]

Anyone aware of new UDS codes for CLIA waived cups. 80305 won't be covered by CMS for a waived facility.

A facility without a valid, current, CLIA certificate, with a current CLIA certificate of waiver (certificate type code 2) or with a current CLIA certificate for provider-performed microscopy procedures (certificate type code 4) must not be permitted to be paid for these tests.

• 80305 - Drug test prsmv dir opt obs;

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3701CP.pdf

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[drpainfree]

My understanding is 80305 was simply a replacement of previous G0477. I believe if you are clia waived, you can bill 80305 for POC UDS.

 

[Pain Applicant1]

Check out that link I gave if you get a chance and the excerpt.

"A facility...with a current CLIA certificate of waiver... must not be permitted to be paid for these tests."

• 80305

It's now considered moderate complexity. You'll start seeing denials.

 

[drpainfree]

so this means we won't get paid for UDS point of care test in office from now on?

 

[pastafan]

https://www.questdiagnostics.com/dms/Documents/Other/CPT-2017/Toxicology_2017_CPT/CPT2017.pdf

 

[Pain Applicant1]

so this means we won't get paid for UDS point of care test in office from now on?

I don't think so. I haven't gotten reimbursed on 80305. Let me know if you do. I've only received denials.

https://www.questdiagnostics.com/dms/Documents/Other/CPT-2017/Toxicology_2017_CPT/CPT2017.pdf

I'm not sure what this means other than saying that G0477 rolled into 80305. It doesn't mention that in order to bill 80305 you must be moderate complexity, not waived.

 

[Pain_doc]

My billing service informed me late last year that G0477 was no longer going to be paid and that I should use 80305. Honestly, I don't know if I getting paid anything. If so, unlikely its more than $5.

 

[Agast]

My billing service informed me late last year that G0477 was no longer going to be paid and that I should use 80305. Honestly, I don't know if I getting paid anything. If so, unlikely its more than $5.

I was using G0477 and it was paying about $12 which at least covered the cost of the POC cup ($5/unit).

 

[drpainfree]

any update on this? I saw first denial of 80305 for DOS of 1/7/2017. Are you guys getting paid for UDS with 80305 now?