Summary & Overview
CPT 0093U: ComplyRX™ LC–MS/MS Urine Multi-Drug Screen
CPT code 0093U designates the ComplyRX™ Proprietary Laboratory Analysis (PLA) from Claro Labs, a urine-based LC–MS/MS assay that detects 65 common prescription drugs. As a PLA code, 0093U maps to a single manufacturer-specific test and is used where payers and providers need to identify this unique laboratory service precisely. Nationally, PLA codes matter because they enable visibility and tracking for proprietary diagnostics that may affect utilization management, lab contracting, and coverage policy.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context and intended use, payer coverage landscape, and typical settings where the service is performed. The publication summarizes benchmark metrics, common billing considerations, and recent policy developments affecting proprietary lab tests, helping billing teams and policy analysts understand reimbursement and administrative implications for a national audience.
This summary covers what the code represents, why it matters, common payer considerations, and the kinds of benchmarks and policy updates addressed in the full publication. Data not available in the input will be noted and omitted from specific tables and charts.
Billing Code Overview
CPT code 0093U is a Proprietary Laboratory Analyses (PLA) code for the ComplyRX™ test developed by Claro Labs. The test uses liquid chromatography–tandem mass spectrometry (LC–MS/MS) of a urine specimen to determine the presence or absence of 65 common prescription drugs in a patient’s body.
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Service type: Clinical laboratory test using LC–MS/MS for multi-drug urine screening
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Typical site of service: Clinical laboratory or outpatient collection site where urine specimens are obtained and sent to the performing laboratory
Clinical & Coding Specifications
Clinical Context
A patient enrolled in an opioid use disorder monitoring program presents to an outpatient laboratory or addiction medicine clinic for urine drug testing using the ComplyRX™ assay. The clinician orders 0093U to detect presence or absence of 65 common prescription medications and their metabolites by liquid chromatography–tandem mass spectrometry (LC–MS/MS) on a urine specimen. Typical clinical workflow: a trained phlebotomy or laboratory collection technician obtains a secured urine sample following chain-of-custody and facility collection protocols; the specimen is sent to Claro Labs or an authorized performing laboratory; the laboratory performs LC–MS/MS analysis and generates a report indicating detected substances and qualitative interpretations; results are routed to the ordering clinician for review during follow-up visits or medication management decisions. Typical sites of service include outpatient laboratories, addiction medicine clinics, primary care clinics with specimen collection, and ambulatory behavioral health centers. Indications include monitoring adherence to prescribed controlled substances, confirming reported medication use, monitoring for illicit drug use, pre- and post-treatment surveillance for pain management or substance use disorder programs, and medico-legal or occupational drug testing when a broad prescription panel is required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |