All PlansCoverageHigh impact
Update for HCPCS Codes G0482 and G0483
Ambetter·GA · Pain Management, Occupational Medicine, Psychiatry +1 more·Medical Policy
Effective date
Jun 4, 2026
We identified it
Aug 26, 2026
Summary
Effective immediately (06/04/26), HCPCS codes G0482 and G0483 for definitive drug testing are no longer reimbursable under 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 to G0480/G0481 with proper medical necessity justification.
Action Required
Effective immediately (06/04/26): (1) Billing team must update billing system to deny/block all claims submitted with HCPCS codes G0482 and G0483 across all payers. (2) Update encounter templates and provider order sets to discontinue use of G0482 and G0483. (3) Configure system to route drug testing orders to codes G0480 and G0481 only, with mandatory medical necessity documentation fields. (4) Notify all providers, lab directors, and clinical staff that definitive drug testing must be billed using G0480/G0481 with clinical justification per CP.MP.50. (5) Audit recent claims (past 30-60 days) for denied G0482/G0483 submissions and submit corrected claims with G0480/G0481. Failure to implement will result in claim denials for all G0482/G0483 submissions.