Procedure Codes for Drug Testing

Effective January 1st, 2016, Medicare’s Final Determination – which the DWC adopted and incorporated – made seven changes to Drug Testing.

As of January 1st, 2016, Medicare’s Final Determination deleted the following drug testing codes:

  • G0431
  • G0434
  • G6030 through G6058

To replace the deleted codes, there are seven new G-codes for drug testing.

3 New Procedure Codes for Presumptive Drug Testing:

  1. G0477
  2. G0478
  3. G0479

NOTE: Only 1 of the 3 presumptive codes allowed per day.

The table below lists the reimbursements for the new presumptive G-codes.

Presumptive Drug Testing Procedure Codes

4 New Procedure Codes for Definitive Drug Testing:

  1. G0480
  2. G0481
  3. G0482
  4. G0483

NOTE: Only 1 of the 4 definitive codes allowed per day.

The table below lists the reimbursements for the new definitive G-codes.
Definitive Drug Testing Procedure Codes

Drug Classes = AMA CPT Manual

Medicare’s Final Determination uses the drug classes listed in the AMA CPT Manual.

Drug classes from AMA CPT Manual

Division of Workers’ Compensation Websites

DWC Official Medical Fee Schedule

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