2025 CPT code 80361
Effective Date: N/A Pathology and Laboratory - Drug Assay Procedures Feed
Opiates, 1 or more.
Modifiers may be applicable to 80361.Modifier 90 indicates that the test was performed by an outside laboratory. Modifier 91 is used for repeat laboratory tests on the same day.Modifier 59 may be necessary when the same test is performed on multiple specimen types.
Medical necessity for 80361 must be supported by the patient's clinical presentation, signs, symptoms, or relevant history. This might include suspected overdose, pain management monitoring, substance abuse evaluation, or other clinically valid reasons for opiate testing.
The lab analyst performs the test to measure or detect the presence of one or more opiates in a patient specimen. They may use methods like gas chromatography or mass spectrometry.
In simple words: This test measures the amount of or detects the presence of one or more opiates in a patient's sample, such as urine or blood.It helps doctors determine if a patient has overdosed on opiates or is following their prescribed medication plan.
Definitive drug identification methods are able to identify individual drugs and distinguish between structural isomers but not necessarily stereoisomers. Definitive methods include, but are not limited to, gas chromatography with mass spectrometry (any type, single or tandem) and liquid chromatography mass spectrometry (any type, single or tandem) and exclude immunoassays (eg, IA, EIA, ELISA, RIA, EMIT, FPIA) and enzymatic methods (eg, alcohol dehydrogenase). Use 80320-80377 to report definitive drug class procedures.
Example 1: A patient presents to the emergency room with suspected opioid overdose. A definitive drug test using 80361 is performed to identify the specific opiate(s) involved., A patient on chronic opioid therapy for pain management undergoes routine urine drug testing (using 80361) to monitor for compliance and ensure they are taking the prescribed medication as directed., A physician suspects a patient is abusing opiates.A definitive urine drug screen (80361) is ordered to detect the presence of opiates and help confirm the diagnosis.
Documentation should include the reason for testing, the specific drug(s) being tested, the specimen type, the test methodology, the results, and their interpretation in the context of the patient's clinical condition. It's important to document the collection method to ensure the validity of the test, especially for urine samples.
- Revenue Code: T1H
- Specialties:Emergency Medicine, Pain Management, Addiction Medicine, Internal Medicine, Family Medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Independent Laboratory, Emergency Room - Hospital, and other places where drug testing is performed