2025 CPT code 80376

Definitive qualitative or quantitative drug testing; 4-6 drugs or substances.

Follow CPT guidelines for definitive drug testing, ensuring appropriate selection based on the number of analytes.Refer to the Definitive Drug Classes Listing for specific drug inclusions.

Modifiers may be applicable (e.g., 90 for outside laboratory, 91 for repeat tests, 59 for multiple specimen types) depending on the circumstances.

Medical necessity is determined based on the clinical indication for testing. Examples include suspicion of drug overdose, monitoring therapeutic drug levels, workplace drug screening, or legal proceedings.

Laboratory personnel perform the test, analyzing the patient specimen for the presence and/or quantity of specific drugs. Physicians order the test to support diagnoses and treatment plans.

IMPORTANT Use 80375 for 1-3 drugs, 80377 for 7 or more drugs.If the specific analyte isn't listed in 80320-80373, use 80375, 80376, or 80377.

In simple words: This lab test checks for the presence and/or amount of four to six specific drugs in a sample (like blood or urine). It uses advanced techniques to accurately identify the drugs.

This CPT code encompasses definitive drug testing, either qualitative or quantitative, for four to six specific drugs or substances.The test identifies individual drugs and distinguishes between structural isomers using methods like gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-mass spectrometry (LC-MS).Immunoassays and enzymatic methods are excluded.

Example 1: A patient presents with symptoms of opioid overdose. A serum sample is sent for definitive testing using code 80376 to identify the specific opioid and determine its concentration., A toxicology screen reveals potential amphetamine use. To confirm and quantify the specific amphetamines present, a urine sample undergoes testing using code 80376., A driver involved in an accident undergoes mandated drug testing.A blood sample is analyzed using code 80376 for the presence of a panel of common drugs of abuse (e.g., cocaine, opioids, benzodiazepines).

Patient demographics, specimen type (blood, urine, etc.), date and time of collection, test request form specifying the drugs to be tested, results of the test with specific drug identification and quantitation (if applicable).

** This code is for definitive testing only. Presumptive testing uses different codes. Results should be interpreted by a qualified healthcare professional.

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