CPT Coding for Basic In-Office Urine Drug Screen with Visual Inspection
For a basic in-office urine drug screen with visual inspection (point-of-care immunoassay), use CPT code 80305 for the drug test procedure itself, which represents qualitative drug class screening using immunoassay methodology.
Understanding the Coding Structure
The current CPT coding system for urine drug testing distinguishes between:
- Point-of-care (POC) immunoassay testing - performed in the office with immediate results 1
- Laboratory-based confirmatory testing - using gas chromatography/mass spectrometry for confirmation 1, 2
Specific CPT Codes for In-Office Drug Screening
CPT 80305 is the appropriate code for:
- Qualitative drug class screening 2
- Immunoassay methodology (the standard for POC testing) 1, 2
- Any number of drug classes tested 2
- Includes visual inspection of the specimen 1
Additional Coding Considerations
When Confirmatory Testing is Needed
If unexpected positive results require confirmation, separate codes apply:
- CPT 80320-80377 - for definitive drug testing by chromatography 2, 3
- These codes are billed separately and only when confirmatory testing is actually performed 1, 3
Documentation Requirements
To support billing, your medical record must include 1:
- Medical necessity using appropriate ICD-10 diagnostic codes
- Documentation of the clinical indication for testing (e.g., monitoring controlled substance therapy, suspected substance use disorder, altered mental status)
- Results interpretation and clinical decision-making based on results
Common Billing Pitfalls to Avoid
Do not use outdated codes: Prior to 2017, codes like 80100 and 80101 were used, but these have been replaced by the current 803XX series 1, 2
Do not separately bill for specimen collection: The visual inspection and basic specimen handling are included in CPT 80305 1
Understand test limitations: Standard immunoassays reliably detect morphine, codeine, and heroin but often miss other opioids like hydrocodone, oxycodone, methadone, fentanyl, and buprenorphine 2, 3. This limitation should inform your clinical interpretation and may necessitate more specific testing.
Confirm positive results before clinical action: False-positive immunoassay results can occur and should be confirmed with definitive testing (gas chromatography/mass spectrometry) before making serious medical or social decisions 3, 4
Clinical Context for Appropriate Use
Urine drug screening is most commonly indicated for 1:
- Monitoring compliance in patients prescribed controlled substances (recommended at least annually)
- Detecting concurrent use of unreported substances that increase overdose risk
- Evaluating patients with altered mental status or suspected intoxication
- Workplace or regulatory requirements
The detection window for most drugs is 1-3 days, though marijuana can be detected for longer periods 2