Key takeaways
- CPT 80305, 80306 and 80307 are presumptive drug screens. Each is reported once per date of service, however many drug classes it checks.
- The code depends on how the result is read: by eye (80305), by instrument-assisted reading (80306) or by an instrument chemistry analyzer (80307).
- Never report two of them on the same date of service.
- A test that identifies and measures specific drugs is definitive: CPT 80320 to 80377, or HCPCS G0480 to G0483 for Medicare.
Presumptive and definitive drug tests
Drug testing has two levels. A presumptive test screens for the presence of a drug class. A definitive test identifies a specific drug or metabolite and, where needed, measures it. Each level has its own codes, and payers limit how often each can be billed.
CPT 80305, 80306 and 80307
| Code | How the result is read | Examples |
|---|---|---|
| 80305 | Direct optical observation only | A dipstick, cup or card read by eye |
| 80306 | Instrument-assisted direct optical observation | A cup or cartridge read by a reader device |
| 80307 | Instrument chemistry analyzers | Immunoassay analyzers, chromatography and mass spectrometry |
All three are reported once per date of service, whatever the number of drug classes tested and the number of devices used. They are not reported together on the same date of service.
Urine drug screen CPT code: which one to use
There is no single urine drug screen code. The code that applies is the presumptive code that matches how your lab reads the result.
- A cup or dipstick read by eye: 80305.
- The same kind of cup read by a reader device: 80306.
- A sample run on an analyzer: 80307.
If your lab uses more than one method on the same date of service, check the payer policy for which code applies, because the three cannot be reported together.
Drug test code finder
Choose how the result is read to see the code.
Definitive drug testing codes
Definitive testing is billed by drug class with CPT 80320 to 80377. Medicare uses HCPCS G0480 to G0483 instead, chosen by how many drug classes were tested, and reported per day.
| HCPCS code | Drug classes tested |
|---|---|
| G0480 | 1 to 7 |
| G0481 | 8 to 14 |
| G0482 | 15 to 21 |
| G0483 | 22 or more |
Medical necessity and denials
Medicare contractors publish local coverage policies for drug testing, and commercial plans set their own limits on how often and how many classes they cover. A claim without documented necessity is denied even when the code is right. The denials we see most often:
- More than one presumptive code on the same date of service.
- A code that does not match the method used to read the result.
- Testing more often than the payer policy allows.
- No documented reason for the test on the requisition or in the record.
Drug test billing FAQ
What is CPT 80305?
CPT 80305 is a presumptive drug test read by direct optical observation only, such as a dipstick, cup or card read by eye. It is reported once per date of service, however many drug classes the device checks.
What is the difference between CPT 80305, 80306 and 80307?
All three are presumptive drug screens reported once per date of service. The difference is how the result is read: 80305 by direct optical observation only, 80306 by instrument-assisted direct optical observation, and 80307 by an instrument chemistry analyzer. Report the one that matches the method used, and never more than one on the same date of service.
What is the CPT code for a urine drug screen?
A presumptive urine drug screen is billed with 80305, 80306 or 80307, depending on how the result is read. A test that identifies and measures specific drugs is definitive testing, billed with CPT 80320 to 80377, or HCPCS G0480 to G0483 for Medicare.
What is the difference between presumptive and definitive drug testing?
Presumptive testing is a screen that shows whether a drug class may be present. Definitive testing identifies the specific drug or metabolite and, where needed, measures it. They are billed with different codes, and payers limit how often each can be billed.
Can 80306 and 80307 be billed together on the same day?
No. CPT 80305, 80306 and 80307 are not reported together on the same date of service. If a lab uses more than one method on the same date, check the payer policy for which single code applies.
How many units of 80305, 80306 or 80307 can be billed?
One unit per date of service, whatever the number of drug classes tested and the number of devices used.
What is the reimbursement rate for CPT 80305?
There is no single rate. Medicare pays presumptive drug tests under the Clinical Laboratory Fee Schedule, which CMS updates each year, and commercial plans and state Medicaid programs publish their own fee schedules. Check the current schedule for each payer you bill, and confirm the payer pays 80305 separately before you build it into your revenue estimate.
Can CPT 80305 be billed to Medicare?
Yes, when the test is medically necessary, ordered by the treating practitioner and documented in the record. Coverage conditions, such as the diagnoses and how often you can test, are set by the local coverage policy of your Medicare Administrative Contractor, so check that policy before you bill. Report the code once per date of service.