Question 1

What is HCPCS code G0431?

Accepted Answer

HCPCS code G0431 is "Drug screen multiple class". Drug screen, qualitative; multiple drug classes by high complexity test method (e.g., immunoassay, enzyme assay), per patient encounter

Question 2

What category is G0431 in?

Accepted Answer

G0431 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0431?

Accepted Answer

Use G0431 when billing for drug screen multiple class. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is G0431 covered by Medicare?

Accepted Answer

Coverage for G0431 (Drug screen multiple class) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for G0431?

Accepted Answer

Documentation for G0431 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).