Attention: All Providers New Presumptive Drug Screening Codes

Effective January 1, 2017, the Centers for Medicare & Medicaid Services (CMS) has end-dated presumptive drug screening codes G0477, G0478, and G0479. CMS made this determination after the Division of Medical Assistance (DMA) completed their annual CPT Update. As a result of this change, DMA is in the process of implementing the new CPT presumptive drug screening codes 80305, 80306, and 80307 effective January 1, 2017 and end-dating G0477-G0479 effective December 31, 2016.

At this time, providers should submit claims for presumptive drug screening using CPT codes 80305-80307. System work has been completed to accept the new presumptive screening claims, however until rates have been entered for the new codes, claims will pend for “no fee on file�. Once the rates for the new codes are entered, the pended claims will recycle automatically. No additional action will be required by providers to ensure that claims process and pay correctly.

A recoupment will take place on a future date for claims paid for G0477-G0479 with dates of service on or after January 1, 2017. Providers may also void paid claims with dates of service on or after January 1, 2017 and resubmit with the new presumptive code that best describes the service performed. Additional information will be provided when a recoupment date has been scheduled. Please refer to the 2017 American Medical Association Current Procedural Terminology (CPT) book for code definitions.