2025 CPT code 80377
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Drug Assay Procedures Pathology and Laboratory Procedures Feed
Definitive drug testing for seven or more drugs or substances; qualitative or quantitative.
Modifiers may be applicable depending on the circumstances.For instance, modifier 59 may be used if the same procedure is performed on multiple specimen types (e.g., blood and urine).
Medical necessity for this code is established when a physician orders the test based on a clinical suspicion of drug use or to monitor adherence to treatment plans. The medical necessity should be supported by the patient’s symptoms, history, and clinical findings.
The clinical responsibility lies with the laboratory personnel who perform the analysis and interpret the results. The ordering physician is responsible for medical necessity and proper interpretation of the results in the context of the patient’s clinical presentation.
In simple words: This lab test checks for seven or more specific drugs or substances in a sample (like urine or blood). It precisely identifies the drugs and measures how much of each is present.
This CPT code encompasses definitive qualitative or quantitative testing for seven or more drugs or substances not otherwise specified.The testing methodology must be able to distinguish between structural isomers. 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 can be qualitative (presence/absence) or quantitative (amount).
Example 1: A patient presents with suspected opioid overdose. A comprehensive toxicology screen (including 80377) is ordered to identify all potentially ingested substances, enabling appropriate treatment., A court-ordered drug screen is required for a probationer. The screen uses 80377 to identify a wide range of drugs for compliance monitoring., A patient is exhibiting unusual symptoms, and the physician suspects the use of multiple illicit drugs.Code 80377 is employed to definitively identify specific drugs and their quantities to guide targeted treatment.
The following documentation is required:
** This code should be used only when a definitive drug identification method is employed.The number of analytes reported, not the test’s capacity, determines the appropriate code.Always consult the most current CPT manual and payer guidelines for accurate coding and reimbursement.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: The RVUs will vary based on geographic location, payer, and other factors. Consult your local fee schedule for specific values.
- Global Days: Not applicable.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Fee schedules vary by payer and location. Consult the relevant fee schedule for historical data.
- Specialties:Toxicology, Emergency Medicine, Addiction Medicine, Forensic Medicine, Internal Medicine, and other specialties depending on the clinical context.
- Place of Service:Office, Hospital (Inpatient/Outpatient), Laboratory, Urgent Care, etc.