June 2016 Updated Crosswalk:
2016 HCPCS
code
Description
HCPCS Codes
deleted for
2016
Description
2015 CPT Code
Description
Radiology Coding
BCBSNC currently considers this service investigational and will not cover either the HCPCS or CPT codes.
G0279
Diagnostic digital breast
tomosynthesis, unilateral or
bilateral (list separately in addition
to G0204 or G0206)
77062
DIGITAL BREAST TOMOSYNTHESIS; BILATERAL
77061
DIGITAL BREAST TOMOSYNTHESIS; UNILATERAL
Radiation Therapy Coding
BCBSNC will reimburse for HCPCS (G code) or CPT code, but not both, for the same date of service
GUIDANCE FOR LOCALIZATION OF TARGET VOLUME
FOR DELIVERY OF RADIATION TREATMENT DELIVERY,
INCLUDES INTRAFRACTION TRACKING, WHEN
PERFORMED
GUIDANCE FOR LOCALIZATION OF TARGET VOLUME
FOR DELIVERY OF RADIATION TREATMENT DELIVERY,
INCLUDES INTRAFRACTION TRACKING, WHEN
PERFORMED
G6001
Ultrasonic guidance for placement
of radiation therapy fields
77387
G6002
Stereoscopic X-ray guidance for
localization of target volume for
the delivery of radiation therapy
77387
G6003
Radiation treatment delivery,
single treatment area, single port
or parallel opposed ports, simple
blocks or no blocks: up to 5MeV
77402
RADIATION TREATMENT DELIVERY, >1 MEV; SIMPLE
G6004
Radiation treatment delivery,
single treatment area, single port
or parallel opposed ports, simple
blocks or no blocks: 6-10MeV
77402
RADIATION TREATMENT DELIVERY, >1 MEV; SIMPLE
Page 1 of 18
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Updated January 2016
Updated July 2015
2016 HCPCS
code
G6005
G6006
G6007
G6008
G6009
G6010
G6011
Description
Radiation treatment delivery,
single treatment area, single port
or parallel opposed ports, simple
blocks or no blocks: 11-19MeV
Radiation treatment delivery,
single treatment area, single port
or parallel opposed ports, simple
blocks or no blocks: 20 MeV or
greater
Radiation treatment delivery, 2
separate treatment areas, 3 or
more ports on a single treatment
area, use of multiple blocks; up to
5MeV
Radiation treatment delivery, 2
separate treatment areas, 3 or
more ports on a single treatment
area, use of multiple blocks; 610MeV
Radiation treatment delivery, 2
separate treatment areas, 3 or
more ports on a single treatment
area, use of multiple blocks; 1119MeV
Radiation treatment delivery, 2
separate treatment areas, 3 or
more ports on a single treatment
area, use of multiple blocks; 20
MeV or greater
Radiation treatment delivery,3 or
more separate treatment areas,
custom blocking, tangential ports,
wedges, rotational beam,
compensators, electron beam; up
to 5MeV
HCPCS Codes
deleted for
2016
Description
2015 CPT Code
Description
77402
RADIATION TREATMENT DELIVERY, >1 MEV; SIMPLE
77402
RADIATION TREATMENT DELIVERY, >1 MEV; SIMPLE
77407
RADIATION TREATMENT DELIVERY, >1 MEV;
INTERMEDIATE
77407
RADIATION TREATMENT DELIVERY, >1 MEV;
INTERMEDIATE
77407
RADIATION TREATMENT DELIVERY, >1 MEV;
INTERMEDIATE
77407
RADIATION TREATMENT DELIVERY, >1 MEV;
INTERMEDIATE
77412
RADIATION TREATMENT DELIVERY, >1 MEV;
COMPLEX
Page 2 of 18
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Updated January 2016
Updated July 2015
2016 HCPCS
code
Description
HCPCS Codes
deleted for
2016
2015 CPT Code
Description
G6012
Radiation treatment delivery,3 or
more separate treatment areas,
custom blocking, tangential ports,
wedges, rotational beam,
compensators, electron beam; 610MeV
Description
77412
RADIATION TREATMENT DELIVERY, >1 MEV;
COMPLEX
G6013
Radiation treatment delivery,3 or
more separate treatment areas,
custom blocking, tangential ports,
wedges, rotational beam,
compensators, electron beam; 1119MeV
77412
RADIATION TREATMENT DELIVERY, >1 MEV;
COMPLEX
G6014
Radiation treatment delivery,3 or
more separate treatment areas,
custom blocking, tangential ports,
wedges, rotational beam,
compensators, electron beam;
20MeV or greater
77412
RADIATION TREATMENT DELIVERY, >1 MEV;
COMPLEX
G6015
(requires preauthorization)
Intensity modulated treatment
delivery, single or multiple
fields/arcs, via narrow spatially
and temporally modulated beams,
binary, dynamic MLC, per
treatment session
77385
(requires pre-authorization)
INTENSITY MODULATED RADIATION TREATMENT
DELIVERY (IMRT), INCLUDES GUIDANCE AND
TRACKING, WHEN PERFORMED; SIMPLE
77386
(requires pre-authorization)
G6016
(requires preauthorization)
Compensator-based beam
modulation treatment delivery of
inverse planned treatment using 3
or more high resolution (milled or
cast) compensator, convergent
beam modulated fields, per
treatment session
INTENSITY MODULATED RADIATION TREATMENT
DELIVERY (IMRT), INCLUDES GUIDANCE AND
TRACKING, WHEN PERFORMED; COMPLEX
INTENSITY MODULATED RADIATION TREATMENT
DELIVERY (IMRT), INCLUDES GUIDANCE AND
TRACKING, WHEN PERFORMED; SIMPLE
77385
(requires pre-authorization)
Page 3 of 18
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Updated January 2016
Updated July 2015
2016 HCPCS
code
Description
HCPCS Codes
deleted for
2016
Description
2015 CPT Code
Description
Drug Toxicology Coding
BCBSNC will reimburse for one HCPCS (G code) OR one CPT code in the same category, but not both, for the same date of service
G0477
G0478
Drug tests(s), presumptive, any
number of drug classes; any
number of devices or procedures,
(eg, immunoassay) capable of
being read by direct optical
observation only (eg, dipsticks,
cups, cards, cartridges), includes
sample validation when
performed, per date of service.
Drug tests(s), presumptive, any
number of drug classes; any
number of devices or procedures,
(eg, immunoassay) read by
instrument-assisted direct optical
observation (eg, dipsticks, cups,
cards, cartridges), includes sample
validation when performed, per
date of service.
G0434
Drug screen, other than
chromatographic; any number of
drug classes, by CLIA waived test or
moderate complexity test, per
patient encounter
80300
G0434
Drug screen, other than
chromatographic; any number of
drug classes, by CLIA waived test or
moderate complexity test, per
patient encounter
80301
DRUG SCREEN, ANY NUMBER OF DRUG CLASSES
FROM DRUG CLASS LIST A; ANY NUMBER OF NON-TLC
DEVICES OR PROCEDURES, (EG, IMMUNOASSAY)
CAPABLE OF BEING READ BY DIRECT OPTICAL
OBSERVATION, INCLUDING INSTRUMENTEDASSISTED WHEN PERFORMED (EG, DIPSTICKS, CUPS,
CARDS, CARTRIDGES), PER DATE OF SERVICE
DRUG SCREEN, ANY NUMBER OF DRUG CLASSES
FROM DRUG CLASS LIST A; SINGLE DRUG CLASS
METHOD, BY INSTRUMENTED TEST SYSTEMS (EG,
DISCRETE MULTICHANNEL CHEMISTRY ANALYZERS
UTILIZING IMMUNOASSAY OR ENZYME ASSAY), PER
DATE OF SERVICE
Page 4 of 18
Updated June 2016
Updated January 2016
Updated July 2015
2016 HCPCS
code
G0479
G0480
Description
Drug tests(s), presumptive, any
number of drug classes; any
number of devices or procedures
by instrumented chemistry
analyzers (eg, immunoassay,
enzyme assay, TOF, MALDI, LDTD,
DESI, DART, GHPC, GC mass
spectrometry), includes sample
validation when performed, per
date of service
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
1-7 drug class(es), including
metabolite(s) if performed
OR
OR
HCPCS Codes
deleted for
2016
Description
2015 CPT Code
80302
G0434
Drug screen, other than
chromatographic; any number of
drug classes, by CLIA waived test or
moderate complexity test, per
patient encounter
80303
80304
Drug screen, other than
chromatographic; any number of
drug classes, by CLIA waived test or
moderate complexity test, per
patient encounter
80355
Description
DRUG SCREEN, PRESUMPTIVE, SINGLE DRUG CLASS
FROM DRUG CLASS LIST B, BY IMMUNOASSAY (EG,
ELISA) OR NON-TLC CHROMATOGRAPHY WITHOUT
MASS SPECTROMETRY (EG, GC, HPLC), EACH
PROCEDURE
DRUG SCREEN, ANY NUMBER OF DRUG CLASSES,
PRESUMPTIVE, SINGLE OR MULTIPLE DRUG CLASS
METHOD; THIN LAYER CHROMATOGRAPHY
PROCEDURE(S) (TLC) (EG, ACID, NEUTRAL, ALKALOID
PLATE), PER DATE OF SERVICE
Drug screen, any number of drug classes,
presumptive, single or multiple drug class method;
not otherwise specified presumptive procedure (eg,
TOF, MALDI, LDTD, DESI, DART), each procedure
GABAPENTIN, NON-BLOOD
G0434
80356
HEROIN METABOLITE
Page 5 of 18
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Updated January 2016
Updated July 2015
2016 HCPCS
code
Description
HCPCS Codes
deleted for
2016
2015 CPT Code
Description
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
8-14 drug class(es), including
metabolite(s) if performed
80357
KETAMINE AND NORKETAMINE
OR
OR
80359
METHYLENEDIOXYAMPHETAMINES (MDA, MDEA,
MDMA)
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
15-21 drug class(es), including
metabolite(s) if performed.)
80360
METHYLPHENIDATE
G0434
Description
Drug screen, other than
chromatographic; any number of
drug classes, by CLIA waived test or
moderate complexity test, per
patient encounter
Page 6 of 18
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Updated January 2016
Updated July 2015
2016 HCPCS
code
OR
G0483
Description
HCPCS Codes
deleted for
2016
Description
OR
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
22 or more drug class(es), including
metabolite(s) if performed.
2015 CPT Code
Description
80366
PREGABALIN
80367
PROPOXYPHENE
80371
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
1-7 drug class(es), including
G0434
Drug screen, other than
chromatographic; any number of
drug classes, by CLIA waived test or
moderate complexity test, per
patient encounter
STIMULANTS, SYNTHETIC
80332
ANTIDEPRESSANTS, SEROTONERGIC CLASS; 1 OR 2
Page 7 of 18
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Updated January 2016
Updated July 2015
2016 HCPCS
code
Description
HCPCS Codes
deleted for
2016
Description
2015 CPT Code
Description
OR
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
8-14 drug class(es), including
metabolite(s) if performed
80333
ANTIDEPRESSANTS, SEROTONERGIC CLASS; 3-5
OR
80348
BUPRENORPHINE
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
80349
CANNABINOIDS, NATURAL
80350
CANNABINOIDS, SYNTHETIC; 1-3
metabolite(s) if performed
OR
G0481
OR
G0482
80334
ANTIDEPRESSANTS, SEROTONERGIC CLASS; 6 OR
MORE
G0434
Drug screen, other than
chromatographic; any number of
drug classes, by CLIA waived test or
moderate complexity test, per
patient encounter
Page 8 of 18
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Updated January 2016
Updated July 2015
2016 HCPCS
code
Description
OR
specimen validity testing, per day,
15-21 drug class(es), including
metabolite(s) if performed.)
.
OR
G0483
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
22 or more drug class(es), including
metabolite(s) if performed
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
HCPCS Codes
deleted for
2016
Description
2015 CPT Code
80351
G0431
Drug screen, qualitative; multiple
drug classes by high complexity test
method (e.g., immunoassay,
enzyme assay), per patient
encounter
Description
CANNABINOIDS, SYNTHETIC; 4-6
80352
CANNABINOIDS, SYNTHETIC; 7 OR MORE
80374
STEREOISOMER (ENANTIOMER) ANALYSIS, SINGLE
DRUG CLASS
Page 9 of 18
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Updated July 2015
2016 HCPCS
code
OR
G0481
Description
specimen validity testing, per day,
1-7 drug class(es), including
metabolite(s) if performed
OR
.
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
8-14 drug class(es), including
metabolite(s) if performed
OR
G0482
HCPCS Codes
deleted for
2016
G6030
or
G6032
or
G6034
or
G6036
or
G6037
Description
Assay of amitriptyline
or
Assay of desipramine
or
Assay of doxepin
or
Assay of imipramine
or
Assay of nortriptyline
OR
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
2015 CPT Code
Description
80335
ANTIDEPRESSANTS, TRICYCLIC AND OTHER
CYCLICALS; 1 OR 2
80336
80337
G6030
or
G6032
or
G6034
or
G6036
or
G6037
Assay of amitriptyline
or
Assay of desipramine
or
Assay of doxepin
or
Assay of imipramine
or
Assay of nortriptyline
ANTIDEPRESSANTS, TRICYCLIC AND OTHER
CYCLICALS; 3-5
ANTIDEPRESSANTS, TRICYCLIC AND OTHER
CYCLICALS; 6 OR MORE
80338
ANTIDEPRESSANTS, NOT OTHERWISE SPECIFIED
Page 10 of 18
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Updated January 2016
Updated July 2015
2016 HCPCS
code
Description
HCPCS Codes
deleted for
2016
Description
2015 CPT Code
Description
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
15-21 drug class(es), including
metabolite(s) if performed.)
OR
G0483
G0480
OR
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
22 or more drug class(es), including
metabolite(s) if performed
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
80335
G6031
or
G6051
Assay of benzodiazepines
or
Assay of flurazepam
80346
BENZODIAZEPINES; 1-12
80347
BENZODIAZEPINES; 13 OR MORE
80375
G6035
Assay of gold
ANTIDEPRESSANTS, TRICYCLIC AND OTHER
CYCLICALS; 1 OR 2
80376
80377
DRUG(S) OR SUBSTANCE(S), DEFINITIVE,
QUALITATIVE OR QUANTITATIVE, NOT OTHERWISE
SPECIFIED; 1-3
DRUG(S) OR SUBSTANCE(S), DEFINITIVE,
QUALITATIVE OR QUANTITATIVE, NOT OTHERWISE
SPECIFIED; 4-6
DRUG(S) OR SUBSTANCE(S), DEFINITIVE,
QUALITATIVE OR QUANTITATIVE, NOT OTHERWISE
SPECIFIED; 7 OR MORE
Page 11 of 18
Updated June 2016
Updated January 2016
Updated July 2015
2016 HCPCS
code
Description
HCPCS Codes
deleted for
2016
Description
G6038
Or
G6039
Assay of salicylate
or
Assay of acetaminophen
2015 CPT Code
Description
80329
ANALGESICS, NON-OPIOID; 1 OR 2
80330
ANALGESICS, NON-OPIOID; 3-5
80331
ANALGESICS, NON-OPIOID; 6 OR MORE
80320
ALCOHOLS
80321
ALCOHOL BIOMARKERS; 1 OR 2
80322
ALCOHOL BIOMARKERS; 3 OR MORE
80323
ALKALOIDS, NOT OTHERWISE SPECIFIED
80324
AMPHETAMINES; 1 OR 2
immunoassays (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
1-7 drug class(es), including
metabolite(s) if performed
OR
G0481
OR
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
8-14 drug class(es), including
metabolite(s) if performed
OR
OR
G0482
Drug test(s), definitive, utilizing
drug identification methods able to
G6040
or
G6050
G6041
or
G6055
G6042
Assay of alcohol (ethanol); any
specimen except breath
or
Assay of ethchlorvynol
Alkaloids, urine, quantitative
or
Assay of nicotine
Amphetamine or
methamphetamine
Page 12 of 18
Updated June 2016
Updated January 2016
Updated July 2015
2016 HCPCS
code
Description
HCPCS Codes
deleted for
2016
Description
2015 CPT Code
Description
80325
AMPHETAMINES; 3 OR 4
80326
AMPHETAMINES; 5 OR MORE
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
15-21 drug class(es), including
metabolite(s) if performed.)
OR
OR
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
22 or more drug class(es), including
metabolite(s) if performed
Page 13 of 18
Updated June 2016
Updated January 2016
Updated July 2015
2016 HCPCS
code
Description
HCPCS Codes
deleted for
2016
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
1-7 drug class(es), including
metabolite(s) if performed
G6043
OR
OR
G6044
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
8-14 drug class(es), including
metabolite(s) if performed
G6045
or
G6046
or
G6056
Description
2015 CPT Code
Description
Barbiturates, not elsewhere
specified
80345
BARBITURATES
80353
COCAINE
80361
OPIATES, 1 OR MORE
Cocaine or metabolite
Assay of dihydrocodeinone
or
Assay of dihydromorphinone
or
Opiate(s), drug and metabolites,
each procedure
Page 14 of 18
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Updated January 2016
Updated July 2015
2016 HCPCS
code
Description
OR
G0482
Description
OR
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
15-21 drug class(es), including
metabolite(s) if performed.)
OR
G0483
HCPCS Codes
deleted for
2016
G6047
or
G6049
Assay of dihydrotestosterone
or
Assay of epiandrosterone
OR
.
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
G6048
or
2015 CPT Code
Description
80362
OPIOIDS AND OPIATE ANALOGS; 1 OR 2
80363
OPIOIDS AND OPIATE ANALOGS; 3 OR 4
80364
OPIOIDS AND OPIATE ANALOGS; 5 OR MORE
80327
ANABOLIC STEROIDS; 1 OR 2
80328
ANABOLIC STEROIDS; 3 OR MORE
80339
ANTIEPILEPTICS, NOT OTHERWISE SPECIFIED; 1-3
80340
ANTIEPILEPTICS, NOT OTHERWISE SPECIFIED; 4-6
80341
ANTIEPILEPTICS, NOT OTHERWISE SPECIFIED; 7 OR
MORE
Assay of dimethadione
or
Page 15 of 18
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Updated January 2016
Updated July 2015
HCPCS Codes
deleted for
2016
Description
immunoassays (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
22 or more drug class(es), including
metabolite(s) if performed
G6054
Assay of methsuximide
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
1-7 drug class(es), including
metabolite(s) if performed
OR
.
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
G6050
Assay of ethchlorvynol
2016 HCPCS
code
G0480
OR
G0481
Description
G6052
Assay of meprobamate
G6053
Methadone
G6041
or
G6055
Alkaloids, urine, quantitative
or
Assay of nicotine
2015 CPT Code
Description
80368
SEDATIVE HYPNOTICS (NON-BENZODIAZEPINES)
80369
SKELETAL MUSCLE RELAXANTS; 1 OR 2
80370
SKELETAL MUSCLE RELAXANTS; 3 OR MORE
80358
METHADONE
80323
ALKALOIDS, NOT OTHERWISE SPECIFIED
Page 16 of 18
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Updated January 2016
Updated July 2015
2016 HCPCS
code
Description
HCPCS Codes
deleted for
2016
Description
2015 CPT Code
Description
Opiate(s), drug and metabolites,
each procedure
80354
FENTANYL
80365
OXYCODONE
80372
TAPENTADOL
80373
TRAMADOL
or tandem) and LC/MS (any type,
single or tandem and excluding
immunoassays (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
8-14 drug class(es), including
metabolite(s) if performed
OR
G0482
OR
.
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
15-21 drug class(es), including
metabolite(s) if performed.)
OR
OR
.
G6056
Page 17 of 18
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Updated January 2016
Updated July 2015
2016 HCPCS
code
G0483
Description
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 (eg, IA, EIA, ELISA,
EMIT, FPIA) and enzymatic
methods (eg, alcohol
dehydrogenase)); qualitative or
quantitative, all sources, includes
specimen validity testing, per day,
22 or more drug class(es), including
metabolite(s) if performed
HCPCS Codes
deleted for
2016
G6057
Description
2015 CPT Code
Description
80342
ANTIPSYCHOTICS, NOT OTHERWISE SPECIFIED; 1-3
80343
ANTIPSYCHOTICS, NOT OTHERWISE SPECIFIED; 4-6
ANTIPSYCHOTICS, NOT OTHERWISE SPECIFIED; 7 OR
MORE
Assay of phenothiazine
80344
Page 18 of 18
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Updated January 2016
Updated July 2015