Quantitative Drug Testing Workgroup Notice (New, Revised and Deleted Codes for 2015)

Transcription

1 The following table is a listing of the new, revised, and deleted codes in the Drug Testing, Therapeutic Drug Assay, and Chemistry sections that will be effective January 1, If an applicant or other interested party believes an action of the CPT Editorial Panel was in error, that individual or entity may submit a code change application to the CPT Editorial Panel. The application and instructions may be obtained by visiting the AMA website. An interested party is an individual or entity that may potentially be impacted by the Panel s decision, regardless of whether they participated in the Panel s original consideration of the matter. Note: Permanent code numbers are not assigned, nor exact wording finalized, until just prior to publication. Codes that contain an 'X' (eg, 1002X4, 234X2X, 0301XT) are placeholder codes that are intended, through the first three digits, to give readers an idea of the proposed placement in the code set of the potential code changes. These codes are not used for claims reporting and will be removed and not retained when the final CPT Datafiles are distributed on August 31st of each year. To report the services for 'X' codes, please refer to the actual codes as they appear in the CPT Datafiles publication distributed on August 31st of each year. Detailed information regarding these codes including, guidelines, parenthetical notes, rationales and clinical examples will be available with the August 31 st release of the CPT code set data files and subsequent educational materials, including CPT Changes 2015: An Insider s View. You may learn more about obtaining these materials by visiting amastore.com Drug screen, qualitative; multiple drug classes chromatographic method, each procedure single drug class method (eg, immunoassay, enzyme assay), each drug class (For qualitative analysis by multiplexed screening kit for multiple drugs or drug classes, use 80104) #80104 multiple drug classes other than chromatographic method, each procedure Drug confirmation, each procedure Tissue preparation for drug analysis 801XXX1 801XX2A 801XX4A 801XXX6 801XXX7 801XY1 Drug screen, any number of drug classes from Drug Class List A; any number of non- TLC devices or procedures, (eg, immunoassay) capable of being read by direct optical observation including instrumented-assisted when performed (eg, dipsticks, cups, cards, cartridges), per date of service single drug class method, by instrumented test systems (eg, discrete multichannel chemistry analyzers utilizing immunoassay or enzyme assay), per date of service Drug screen, presumptive, single drug class from Drug Class List B, by immunoassay (eg, ELISA) or non-tlc chromatography without mass spectrometry (eg, GC, HPLC), each procedure Drug screen, any number of drug classes, presumptive, single or multiple drug class method; thin layer chromatography procedure(s) (TLC)(eg, acid, neutral, alkaloid plate), per date of service not otherwise specified presumptive procedure (eg, TOF, MALDI, LDTD, DESI, DART), each procedure Alcohols 801XY2 Alcohol biomarkers; 1 to 2

2 801XY3 3 or more 801XY44 Alkaloids, not otherwise specified 801XY18 Amphetamines, 1 to 2 801XY19 3 to 4 801XY20 5 or more 801XY44A Anabolic steroids XY44B 3 or more 801XY28 Analgesics, non-opioid; 1 to 2 drugs 801XY29 3 to 5 801XY30 6 or more 801XY22 Antidepressants, serotonergic class; 1 to 2 drugs 801XY23 3 to 5 801XY24 6 or more 801XY25 Antidepressants, tricyclic and other cyclicals; 1 to 2 drugs 801XY26 3 to 5 801XY27 6 or more 801XY27A Antidepressants, not otherwise specified 801XY34 Antiepileptics, not otherwise specified; 1 to 3 drugs 801XY35 4 to 6 801XY36 7 or more 801XY31 Antispychotics, not otherwise specified; 1 to 3 drugs 801XY32 4 to 6 801XY33 7 or more 801XY4 Barbiturates 801XY5 Benzodiazepines; XY6 13 or more 801XY12 Buprenorphine 801XY37 Cannabinoids, natural 801XY38 Cannabinoids, synthetic 1 to 3 801XY39 4 to 6 801XY40 7 or more 801XY43 Cocaine 801XY13 Fentanyl 801XY13B Gabapentin, non-blood 801XY9 Heroin metabolite

3 801XY9A 801XY10 801XY17B 801XY17C 801XY7 Ketamine and norketamine Methadone Methylenedioxyamphetamines (MDA, MDEA, MDMA) Methylphenidate Opiates, one or more 801XY15 Opioids and opiate analogs; 1 to 2 801XY16 3 to 4 801XY17 801XY8 801XY13A 801XY7A 801XY7B Oxycodone Pregabalin 5 or more Propoxyphene Sedative hypnotics (non-benzodiazepines) 801XY14 Skeletal muscle relaxants; XX14A 801XY41 801XY42 801XY48 801XY17A 801XY45 3 or more Stimulants, synthetic Tapentadol Tramadol 801XY46 4 to 6 801XY Amitriptyline Stereoisomer (enantiomer) analysis, single drug class Drug(s) or substance(s), definitive, qualitative or quantitative, not otherwise specified; 1 to 3 7 or more Benzodiazepines Desipramine XXX XXX11 Digoxin; total Doxepin Gold free Dipropylacetic acid (valproic acid) Valproic acid (dipropylacetic acid); total free Imipramine Nortriptyline #84228 Quinine Gabapentin, whole blood, serum or plasma

4 80196 Salicylate Quantitation of therapeutic drug, not elsewhere specified Acetaldehyde, blood Acetaminophen Alcohol (ethanol); any specimen except breath Alkaloids, urine, quantitative Amphetamine or metaamphetamine Barbiturates, not elsewhere specified Cocaine or metabolite Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), non-drug analyte not elsewhere specified; qualitative, single stationary and mobile phase Dihydrocodeinone Dihydromorphinone Dihydrotestosterone (DHT) Dimethadione Epiandrosterone Ethchlorvynol Flurazepam Glutethimide Methadone Methsuximide Nicotine stable isotope dilution, multiple analytes, quantitative, single stationary and mobile phase Opiate(s), drug and metabolites, each procedure Phenothiazine Volatiles (eg, acetic anhydride, carbon tetrachloride, dichloroethane, dichloromethane, diethylether, isopropyl alcohol, methanol)

5 Drug Class A Alcohol (Ethanol) Amphetamines Barbiturates Benzodiazepines Buprenorphine Cocaine metabolite Heroin metabolite (6-monoacetylmorphine) Methadone Methadone metabolite (EDDP) Methamphetamine Methaqualone Methylenedioxymethamphetamine (MDMA) Opiates Oxycodone Phencyclidine Propoxyphene Tetrahydrocannabinol (THC) metabolites (marijuana) Tricyclic Antidepressants Drug Class B Acetaminophen Carisoprodol/Meprobamate Ethyl Glucuronide Fentanyl Ketamine Meperidine Methylphenidate Nicotine/Cotinine Salicylate Synthetic Cannabinoids Tapentadol Tramadol Zolpidem Not otherwise specified

6 Definitive Drug Classes Listing Codes Classes Drugs 801XY1 Alcohol(s) Acetone, Ethanol, ethchlorvynol, ethylene glycol, isopropanol, isopropyl alcohol, methanol 801XY2-801XY3 Alcohol Biomarkers Ethanol conjugates (ethyl glucuronide [ETG], ethyl sulfate [ETS], fatty acid ethyl esters, phosphatidylethanol) 801XY44 801XY18-801XY20 801XY44A- 801XY44B 801XY28-801XY30 801XY22-801XY24 801XY25-801XY27 801XY27A 801XY34-801XY36 Alkaloids, not otherwise specified Amphetamines 7-Hydroxymitragynine, atropine, cotinine, lysergic acid diethylamide (LSD), mescaline, mitragynine, nicotine, psilocin, psilocybin, scopolamine Amphetamine, ephedrinelisdexamphetamine, methamphetamine, phentermine, phenylpropanolamine, pseudoephedrine Anabolic steroids 1-Androstenediol, 1-androstenedione, 1- testosterone, 4-hydroxy-testosterone, 6oxo, 19- norandrostenedione, androstenedione, androstanolone, bolandiol, bolasterone, boldenone, boldione, calusterone, clostebol, danazol, dehydrochlormethyltestosterone, dihydrotestosterone, drostanolone, epiandrosterone, epitestosterone, fluoxymesterone, furazabol, mestanolone, mesterolone, methandienone, methandriol, methenolone, methydienolone, methyl-1-testosterone, methylnortestosterone, methyltestosterone, mibolerone, nandrolone, norbolethone, norclostebol, norethandrolone, norethindrone, oxabolone, oxandrolone, oxymesterone, oxymetholone, stanozolol, stenbolone, tibolone, trenbolone, zeranol Analgesics, non-opioid Acetaminophen, diclofenac ibuprofen, ketoprofen, naproxen, oxaprozin, salicylate Antidepressants, serotonergic Citalopram, duloxetine, escitalopram, fluoxetine, class fluvoxamine, paroxetine, sertraline Antidepressants, Tricyclic and other cyclicals Antidepressants, not otherwise specified Antiepileptics Amitriptyline, amoxapine, clomipramine, demexiptiline, desipramine, doxepin, imipramine, maprotiline, mirtazpine, nortriptyline, protriptyline, Bupropion, desyenlafaxine, isocarboxazid, nefazodone, phenelzine, selegiline, tranylcypromine, trazodone, venlafaxine Carbamazepine, clobazam, diamethadione, ethosuximide, ezogabine, lamotrigine, levetiracetam, methsuximide, oxcarbazepine, phenytoin, primidone, rufinamide, tiagabine, topiramate, trimethadione, valproic acid, zonisamide

7 801XY31-801XY33 Antipsychotics Aripiprazole, chlorpromazine, clozapine, fluphenazine, haloperidol, loxapine, mesoridazine, molindone, olanzapine, paliperidone, perphenazine, phenothiazine, pimozide, prochlorperazine, quetiapine, risperidone, trifluoperazine, thiothixene, thoridazine, ziprasidone 801XY4 Barbiturates Amobarbital, aprobarbital, butalbital, cyclobarbital, mephobarbital, pentobarbital, phenobarbital, secobarbital, talbutal, thiopental 801XY5, 801XY6 Benzodiazepines Alprazolam, chlordiazepoxide, clonazepam, clorazepate, diazepam, estazolam, flunitrazepam, flurazepam, halazepamlorazepammidazolam, nitrazepam, nordazepam, oxazepam, prazepam, quazepam, temazepam 801XY12 Buprenorphine Buprenorphine 801XY37 Cannabinoids, natural Marijuana, dronabinol carboxy-thc 801XY38-801XY40 Cannabinoids, synthetic CP-47,497, CP497 C8-homolog, JWH-018 and AM678, JWH-073, JWH-019, JWH-200, JWH- 210, JWH-250, JWH-081, JWH-122, HWH-398, AM-2201, AM-694, SR-19 and RCS-4, SR-18 and RCS-8, JWH-203, UR-144, XLR-11, MAM- 2201, AKB XY43 Cocaine Benzoylecgonine, cocaethylene, cocaine, ecgonine methyl ester, norcocaine 801XY13 Fentanyls Acetylfentanyl, alfentanil, fentanyl, remifentanil, sufentanil 801XY13B Gabapentin, non-blood gabapentin 801XY9 Heroin metabolite 6-acetylmorphine, acetylcodeine, diacetylmorphine 801XY7B Hypnotics, sedative (nonbenzodiazepines) See Sedative Hypnotics 801XY9A Ketamine and Norketamine Ketamine, norketamine 801XY10 Methadone Methadone and EDDP 801XY17B Methylenedioxyamphetamines MDA, MDEA, MDMA Staff Note: AMA Staff mistakenly mislabeled assignment of X code to this material. The above reflects correction. 801XY17C Methylphenidate Methylphenidate, ritalinic acid 801XY9A Norketamine see Ketamine 801XY7B Non-Benzodiazepines see Hypnotics, sedative 801XY7 Opiates Codeine, dihydrocodeine, hydrocodone, hydromorphone, morphine 801XY15-801XY17 Opioids and opiate analogs Butorphanol, desomorphine, dextromethorphan, dextrorphan, levorphanol, meperidine, naloxone, naltrexone, normeperidine, pentazocine, 801XY8 Oxycodone Oxycodone, oxymorphone 801XY21 Phencyclidine Phencyclidine 801XY13A Pregabalin Pregabalin 801XY7A Propoxyphene Norpropoxyphene, propoxyphene

8 801XY7B Sedative Hypnotics Eszopiclone, Zaleplon, Zolpidem 801XY14-801XY14A Skeletal muscle relaxants Baclofen, carisoprodol, cyclobenzaprine, metaxalone, methocarbamol, orphenadrine, tizanidide. 801XY41 Stimulants, synthetic 2C-B, 2C-E, 2C-I, 2C-H, 3TFMPP, 4- methylethcathinone, alpha-pvp, benzylpiperazine, bromodragonfly, cathinone, m-cpp, MDPBP, MDPPP, MDPV, mephedrone, methcathinone, methylone, phenethylamines, salvinorin, tryptamines 801XY42 Tapentadol Tapentadol 801XY48 Tramadol Tramadol