Attention: All Providers Rates Loaded for New Presumptive Drug Screening Codes

[This is an update to the article posted on the provider portal on January 24.]

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

Rates for the new presumptive drug screening codes were loaded in the system on January 26. Any claims that previously pended for “no fee on file� will recycle automatically. No additional action is 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.