Code

Description

80305

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

80306

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

80307

Drug test(s), presumptive, any number of drug classes, any number of devices or procedures, by instrument chemistry analyzers (e.g., utilizing immunoassay [e.g., EIA, ELISA, EMIT, FPIA, IA, KIMS, RIA]), chromatography (e.g., GC, HPLC), and mass spectrometry either with or without chromatography, (e.g., DART, DESI, GC-MS, GC- MS/MS, LC-MS, LC-MS/MS, LDTD, MALDI, TOF) includes sample validation when performed, per date of service

80324

Amphetamines; 1 or 2

80325

Amphetamines; 3 or 4

80326

Amphetamines; 5 or more

80327

Anabolic steroids; 1 or 2

80328

Anabolic steroids; 3 or more

80329

Analgesics, non-opioid; 1 or 2

80330

Analgesics, non-opioid; 3-5

80331

Analgesics, non-opioid; 6 or more

80332

Antidepressants, serotonergic class; 1 or 2

80333

Antidepressants, serotonergic class; 3-5

80334

Antidepressants, serotonergic class; 6 or more

80335

Antidepressants, tricyclic and other cyclicals; 1 or 2

80336

Antidepressants, tricyclic and other cyclicals; 3-5

80337

Antidepressants, tricyclic and other cyclicals; 6 or more

80338

Antidepressants, not otherwise specified

Code

Description

80339

Antiepileptics, not otherwise specified; 1-3

80340

Antiepileptics, not otherwise specified; 4-6

80341

Antiepileptics, not otherwise specified; 7 or more

80342

Antipsychotics, not otherwise specified; 1-3

80343

Antipsychotics, not otherwise specified; 4-6

80344

Antipsychotics, not otherwise specified; 7 or more

80345

Barbiturates

80346

Benzodiazepines; 1-12

80347

Benzodiazepines; 13 or more

80348

Buprenorphine

80349

Cannabinoids, natural

80350

Cannabinoids, synthetic; 1-3

80351

Cannabinoids, synthetic; 4-6

80352

Cannabinoids, synthetic; 7 or more

80353

Cocaine

80354

Fentanyl

80355

Gabapentin, non-blood

80356

Heroin metabolite

80357

Ketamine and norketamine

80358

Methadone

80359

Methylenedioxyamphetamines (MDA, MDEA, MDMA

80360

Methylphenidate

80361

Opiates, 1 or more

80362

Opioids and opiate analogs; 1 or 2

80363

Opioids and Opiate analogs; 3 or 4

80364

Opioids and Opiate analogs; 5 or more

80365

Oxycodone

Code

Description

80366

Pregabalin

80367

Propoxyphene

80368

Sedative hypnotics (non-benzodiazepines

80369

Skeletal muscle relaxants; 1 or 2

80370

Skeletal muscle relaxants; 3 or more

80371

Stimulants, synthetic

80372

Tapentadol

80373

Tramadol

80374

Stereoisomer (enantiomer) analysis, single drug class

80375

Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1-3

80376

Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 4-6

80377

Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 7 or more

83992

Phencyclidine (PCP)

81000

Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy

81001

Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy

81002

Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy

81003

Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy

81005

Urinalysis; qualitative or semiquantitative, except immunoassays

81015

Urinalysis; microscopic only

81025

Urine pregnancy test, by visual color comparison methods

82043

Albumin; urine, microalbumin, quantitative

82044

Albumin; urine, microalbumin, semiquantitative (e.g., reagent strip assay)

82247

Bilirubin; total

Code

Description

82270

Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (i.e., patient was provided 3 cards or single triple card for consecutive collection)

82271

Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; other sources

82272

Blood, occult, by peroxidase activity (e.g., guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening

82465

Cholesterol, serum or whole blood, total

82565

Creatinine; blood

82731

Fetal fibronectin, cervicovaginal secretions, semi-quantitative

82947

Glucose; quantitative, blood (except reagent strip)

82948

Glucose; blood, reagent strip

82950

Glucose; post glucose dose (includes glucose)

82951

Glucose; tolerance test (GTT), 3 specimens (includes glucose)

82952

Glucose; tolerance test, each additional beyond 3 specimens (List separately in addition to code for primary procedure)

82962

Glucose, blood by glucose monitoring device(s) cleared by the U. S. Food and Drug Administration (FDA) specifically for home use

83036

Hemoglobin; glycosylated (A1C)

83037

Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use

83655

Lead

83986

pH; body fluid, not otherwise specified

84132

Potassium; serum, plasma or whole blood

84703

Gonadotropin, chorionic (hCG); qualitative

85013

Blood count; spun microhematocrit

85014

Blood count; hematocrit (Hct)

85018

Blood count; hemoglobin (Hgb)

85025

Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count

85027

Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count

85049

Blood count; platelet, automated

85610

Prothrombin time

Code

Description

85651

Sedimentation rate, erythrocyte; non-automated

86308

Heterophile antibodies; screening

86580

Skin test; tuberculosis, intradermal

86756

Antibody; respiratory syncytial virus

87070

Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates

87172

Pinworm exam (e.g., cellophane tape prep

87205

Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types

87210

Smear, primary source with interpretation; wet mount for infectious agents (e.g., saline, India ink, KOH preps)

87220

Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (e.g., scabies)

87270

Infectious agent detection, by immunofluorescent technique, chlamydia trachomatis

87490

Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique

87491

Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique

87492

Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, quantification

87802

Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group B

87803

Infectious agent antigen detection by immunoassay with direct optical observation; Clostridium difficile toxin A

87804

Infectious agent antigen detection by immunoassay with direct optical observation; Influenza

87807

Infectious agent antigen detection by immunoassay with direct optical observation; respiratory syncytial virus

87808

Infectious agent antigen detection by immunoassay with direct optical observation; Trichomonas vaginalis

87880

Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group A

87905

Infectious agent enzymatic activity other than virus (e.g., sialidase activity in vaginal fluid)

Code

Description

G0480

Drug test(s), definitive, utilizing (1) 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)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix- matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed

G0481

Drug test(s), definitive, utilizing (1) 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)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix- matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8- 14 drug class(es), including metabolite(s) if performed

G0482

Drug test(s), definitive, utilizing (1) 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)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix- matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15- 21 drug class(es), including metabolite(s) if performed

G0483

Drug test(s), definitive, utilizing (1) 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)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix- matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed

G0659

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), excluding immunoassays (e.g., IA, EIA, ELISA, EMIT, FPIA) and enzymatic methods (e.g., alcohol dehydrogenase), performed without method or drug-specific calibration, without matrix-matched quality control material, or without use of stable isotope or other universally recognized internal standard(s) for each drug, drug metabolite or drug class per specimen; qualitative or quantitative, all sources, includes specimen validity testing, per day, any number of drug classes

Code

Description

Q0111

Wet mounts, including preparations of vaginal, cervical or skin specimens

Q0112

All potassium hydroxide (KOH) preparations