2025 CPT code 80375
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Drug Assay Procedures Pathology and Laboratory Procedures Feed
Definitive drug testing for one to three substances; qualitative or quantitative.
Modifiers may be applicable in certain circumstances, such as modifier 59 (distinct procedural service) if the same procedure is performed on multiple specimen types, or other modifiers as per payer guidelines.
Medical necessity for this test is determined by the clinician based on the patient's clinical presentation, symptoms, history, and potential drug exposure.Specific reasons for testing may include but are not limited to suspected overdose, driving under the influence, workplace screening, or monitoring therapeutic drug levels (when appropriate definitive tests are used).
Laboratory analysts are responsible for performing the test, analyzing results, and reporting findings. Clinicians order the tests based on medical necessity.
In simple words: This lab test checks for one to three specific drugs in a sample (like blood or urine). It uses advanced methods to precisely identify and measure the amounts of the drugs present.
This CPT code encompasses definitive qualitative or quantitative testing for one to three drugs or substances not otherwise specified.Definitive methods include, but aren't limited to, gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-MS).Immunoassays and enzymatic methods are excluded. Results may be qualitative (presence/absence) or quantitative (amount measured). Each drug or metabolite is reported only once per date of service, except for separately listed metabolites in the Definitive Drug Classes Listing.Metabolites not listed can be reported under the parent drug code.
Example 1: A patient presents with symptoms of opioid overdose.A blood sample is tested using LC-MS/MS to identify and quantify the presence of opioids such as morphine, codeine, and oxycodone.Code 80375 is reported if one to three opioids are identified., A patient is suspected of driving under the influence of drugs.A urine sample is analyzed using GC-MS to detect the presence of amphetamines, cocaine metabolites, and cannabinoids. If one to three substances are detected, code 80375 is appropriate., A workplace drug screening program requires definitive testing for a panel of substances including opioids, cocaine, and benzodiazepines. If one to three substances are detected using appropriate definitive methods, this code is used.
* Patient demographics and unique identifier.* Date and time of specimen collection.* Specimen type (e.g., blood, urine).* Testing method (e.g., GC-MS, LC-MS).* Results (qualitative and/or quantitative for each analyte).* Clinician's order indicating medical necessity.
** Always refer to the current CPT manual for the most up-to-date information and coding guidelines.Ensure accurate documentation to support the medical necessity for the test.Proper coding practices are essential for accurate billing and reimbursement.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: Information not available in provided text.Consult the AMA CPT manual or other relevant fee schedules for RVU data.
- Global Days: Not applicable.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Fee schedule information is not provided in the source documents. Consult your payer’s specific fee schedule for accurate reimbursement rates.
- Specialties:Clinical Chemistry, Toxicology, Forensic Medicine, Emergency Medicine
- Place of Service:Office, Hospital (Inpatient and Outpatient), Laboratory, Urgent Care,Emergency Room,Other Place of Service (as clinically appropriate)