Facility Type Code - Drug Testing 80305 & 80307

dsalazar 3 years ago in Billing/Electronic Modules updated 3 years ago 5

Does anyone know what facility type code we should use for drug testing codes such as 80305 & 80307. I've been using code 89 but one payer is denying our claims because it's the wrong facility code type. They won't tell me what code they want us to use and they just said to talk to our biller. I am the biller and I've not been able to find this information. If anyone can assist please reply. We do drug test lab screenings at our facility. Thanks.

Hi there!  I bill 80305 with place of service 11 (office) and they're billed as professional services rather than facility.  I have no issues getting my UAs paid.  Make sure your CLIA number is entered in the payer as well.

Thank you for the reply! I have a follow up question for clarification. I've been using Office 11 too for the location. But what code do you use in the "admissions" tab "facility" dropdown? This is the facility type code that we're being denied for. I had been using "89" which is getting us denials. 

You should be billing your UAs via the 1500 professional claim format.  The information in the admissions tab does not populate in the 1500 claim format.  In each payer, make sure on the Payer Rules tab that the setting for Source of NPI is Clinic.  

As long as all these things are set up correctly, and you're billing via the professional claim, you should not get denials.

I agree with Heather. I have had no problems billing 80307 with POS 11 and they should be billing as a professional claim so the Facility type should not be visible anywhere. 

Thank you. I will try sending it out as a professional claim. I had been sending it out as institutional.