2025 HCPCS code G0483
(Active) Effective Date: N/A Revision Date: N/A Laboratory Services - Definitive Drug Testing Other Services Feed
Definitive drug testing for 22 or more drug classes, including validity testing.
Modifiers may be applicable depending on the specific circumstances, such as the place of service, the type of testing performed, and the provider's role.
Medical necessity is established based on the patient's clinical presentation, history, and risk factors. Documentation supporting the need for comprehensive testing must be present in the medical record.
Clinical laboratory personnel perform the testing and analysis. Ordering physician is responsible for medical necessity and interpretation of results.
In simple words: This lab test checks for 22 or more types of drugs and their byproducts in a blood or urine sample. It precisely measures the amount of each substance found.
This HCPCS code encompasses definitive drug testing, which involves identifying and/or quantifying specific drugs and metabolites for 22 or more drug classes in a patient specimen (e.g., urine or blood).The testing may be qualitative or quantitative.Methods may include gas chromatography/mass spectrometry (GC/MS), liquid chromatography/mass spectrometry (LC/MS) (excluding immunoassays), or enzymatic methods.The test includes specimen validity testing.
Example 1: A patient presents to the emergency department following a suspected drug overdose. A comprehensive toxicological screen (G0483) is ordered to identify all potential substances involved., A patient is undergoing substance abuse treatment.Regular definitive drug testing (G0483) is performed to monitor compliance with their treatment plan and detect any illicit drug use., A patient with unexplained altered mental status is admitted to the hospital.A comprehensive panel (G0483) is utilized to identify any potential contributing factors.
* Signed physician order specifying the need for the test.* Patient’s clinical history, including symptoms, physical exam findings, and past medical history.* Documentation of the medical necessity for the test, including the clinical indications.* Complete test results, including the identification and quantification of specific drugs and metabolites.
** Coverage and reimbursement for G0483 may vary significantly based on payer, state, and specific clinical scenario. Always verify coverage with the relevant payer before submitting claims.
- Payment Status: Active (but may vary by payer)
- Specialties:Toxicology, Addiction Medicine, Emergency Medicine, Clinical Chemistry
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Outpatient Hospital, Ambulatory Surgical Center