All PlansCoverageHigh impact
Update for HCPCS Codes G0482 and G0483
Ambetter·NH · Pain Management, Psychiatry, Occupational Medicine +1 more·Medical Policy
Effective date
Jun 10, 2026
We identified it
Aug 26, 2026
Summary
Effective immediately (06/10/2026), HCPCS codes G0482 and G0483 for definitive drug testing are no longer reimbursable by this payer, aligning with Clinical Policy CP.MP.50. Codes G0480 and G0481 remain covered when medical necessity is documented. Billing teams must stop submitting claims for G0482 and G0483 and redirect applicable drug testing claims to G0480/G0481 with proper medical necessity documentation.
Action Required
Effective immediately (06/10/2026): Billing team must take the following actions: (1) Update billing software to DENY or BLOCK submission of HCPCS codes G0482 and G0483 for this payer; (2) Redirect all drug testing claims previously coded as G0482 or G0483 to alternative covered codes G0480 or G0481; (3) Ensure providers document medical necessity on all drug testing claims submitted under G0480/G0481 to meet coverage requirements; (4) Review and correct any claims for G0482/G0483 currently in pending status before they are processed and denied; (5) Communicate this change to all clinical staff who order drug testing, with specific instructions to use G0480/G0481 instead. Failure to implement this change will result in claim denials and revenue loss for drug testing services.