2025 CPT code 80362
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Drug Assay Procedures Pathology and Laboratory Procedures Feed
Qualitative or quantitative analysis of one or two opioids and their analogs in a patient specimen.
Modifiers may apply depending on the circumstances of service.Consult the CPT manual and your payer's guidelines for appropriate modifier usage.
Medical necessity for 80362 is established based on clinical suspicion of opioid use, monitoring compliance with prescribed opioid regimens, evaluating suspected overdose, or investigating potential non-compliance in substance abuse treatment programs.Documentation should clearly justify the medical rationale for ordering the test.
The clinical responsibility lies with the ordering physician who interprets the results in the context of the patient's clinical presentation. The laboratory is responsible for accurate performance and reporting of the test.
In simple words: This lab test checks for one or two specific types of opioid pain medications or similar substances in a sample from your body (like blood or urine). It uses advanced techniques to accurately measure the amount present or simply detect if they are there.
This CPT code encompasses the qualitative or quantitative analysis of one or two opioids and their analogs (opiate derivatives) in a patient specimen using definitive methods.Definitive methods include techniques like gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-mass spectrometry (LC-MS), capable of distinguishing between structural isomers.The test may be qualitative (positive/negative), quantitative (amount measured), or a combination of both. Specimens may include urine, blood, or other suitable matrices.
Example 1: A patient presents to the emergency department with suspected opioid overdose.80362 is used to identify the specific opioid(s) involved and quantify their concentration to guide treatment., A patient is enrolled in a drug rehabilitation program.Periodic testing using 80362 is conducted to monitor compliance with their prescribed medication regimen and to detect any potential use of other non-prescribed opioids., A post-surgical patient reports persistent pain, and the physician suspects that the patient may be using additional, non-prescribed opioids.A blood test using 80362 is ordered to investigate this possibility.
* Physician's order specifying the test requested (80362).* Patient's demographics and medical history.* Specimen collection date and time.* Specimen type (e.g., urine, blood).* Complete laboratory report with qualitative or quantitative results, including identification of the specific opioid(s) and their concentrations (if applicable).* Method of analysis used.
** Always cross-reference with the most up-to-date CPT manual and payer guidelines for accurate billing and reimbursement.
- Revenue Code: T1H (LAB TESTS - OTHER)
- RVU: This information is not readily available.Consult the current year's Medicare Physician Fee Schedule or other relevant payer guidelines for RVU values and reimbursement details.
- Global Days: Not applicable. This is a laboratory test, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable to this laboratory procedure.
- Fee Schedule: Fee schedule data is not provided.Check the current Medicare Physician Fee Schedule or other relevant payer guidelines for reimbursement details.
- Specialties:Clinical Chemistry, Toxicology, Addiction Medicine, Emergency Medicine
- Place of Service:Office, Hospital (inpatient/outpatient), Laboratory, Urgent Care Facility, Emergency Room