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BETA v.3.0

2025 CPT code 80354

Fentanyl

This code should be reported once per date of service, even if both qualitative and quantitative tests are performed on the same specimen. Modifier 59 should be used if the same procedure is performed on different specimen types.

Modifiers such as 90 (reference lab), 91 (repeat testing), and 99 (multiple modifiers) may apply if appropriate. Additional modifiers may be necessary to properly document the context of testing, particularly for Medicare and other federally regulated programs.

Medical necessity for this test is determined by the clinical rationale for ordering the test, such as monitoring therapeutic levels, confirming suspected overdose, assessing compliance, or evaluating unexplained symptoms.

The lab analyst performs the test to measure or detect fentanyl in the provided patient specimen. Methodologies like liquid chromatography may be used to separate and quantitate the fentanyl from the specimen.

In simple words: This lab test measures how much fentanyl is in a patient's sample, like urine or blood. It helps doctors check if someone is taking their fentanyl medication as prescribed or if they might have overdosed.

This test measures the presence or quantity of fentanyl in a patient specimen, such as urine or serum. It uses methods like liquid chromatography to isolate and quantify the fentanyl. The test can be qualitative (positive/negative), quantitative (measuring the amount), or a combination of both.

Example 1: A patient with chronic pain managed with fentanyl patches undergoes routine testing to ensure therapeutic levels and monitor compliance., An emergency room physician orders a fentanyl test on a suspected overdose patient to confirm the presence and quantity of the drug., A pain management clinic uses fentanyl testing to monitor prescribed fentanyl usage in patients with a history of substance abuse.

Documentation should include the reason for testing, the specimen type, the testing methodology, and the results.

** It is crucial to distinguish this definitive drug test from presumptive drug tests, which are less specific. This test identifies individual drugs and isomers, while presumptive tests may not.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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