Summary & Overview
CPT 0587U: SafeDrugs LC MS/MS Drug Panel with Algorithm Risk Score
CPT code 0587U is a Proprietary Laboratory Analyses (PLA) code assigned to the SafeDrugs test from Astraeus Lab LLC and Quantlio Technologies. The test employs liquid chromatography–tandem mass spectrometry (LC MS/MS) on urine or saliva to quantify a broad panel of drugs and metabolites, verify sample integrity, and produce an algorithm-generated risk score indicating potential for adverse drug interactions or toxicity. As a PLA code, 0587U applies only to this specific manufacturer’s assay, which affects coding clarity and payer review.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of what the code represents, typical sites of service, and clinical context for laboratory-based drug monitoring and toxicity risk assessment. The publication summarizes common modifiers and highlights where data was not provided.
This report helps billing managers, laboratory directors, and policy analysts understand the clinical function of the assay, the limited scope of a PLA code, and the payer landscape to consider when coding and submitting claims. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 0587U is a Proprietary Laboratory Analyses (PLA) code that applies uniquely to the SafeDrugs test manufactured by Astraeus Lab LLC and Quantlio Technologies. The assay uses liquid chromatography with tandem mass spectrometry (LC MS/MS) to quantify a broad panel of drugs and their metabolites in urine or saliva, confirm sample integrity, and generate an algorithm-derived risk score estimating a patient’s likelihood of adverse drug interactions or toxicity.
Service type: Proprietary laboratory test using LC MS/MS with algorithm-generated risk scoring.
Typical site of service: Clinical laboratory or outpatient specimen collection site (urine or saliva).
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with chronic pain and multiple outpatient prescriptions presents to a primary care clinic for medication management after recent reports of dizziness and gastrointestinal upset. The clinician orders a urine-based toxicology panel, 0587U (SafeDrugs, Astraeus Lab LLC / Quantlio Technologies), to quantify prescribed and non-prescribed drugs and metabolites, confirm sample integrity, and generate an algorithm-derived risk score for potential adverse drug interactions or toxicity. The specimen is collected in clinic (urine or saliva), sent to the performing laboratory, and results are routed to the prescribing clinician. The laboratory performs LC-MS/MS analysis, assesses specimen validity, and provides a numeric risk score used by the clinician during a follow-up visit to guide medication reconciliation and risk assessment. Typical sites of service include outpatient primary care clinics, pain management clinics, behavioral health clinics, and outpatient laboratory collection centers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default professional and technical components intact (no modifier) | Use when test is billed as the single PLA code without special circumstances. |
22 | Increased procedural services | Use when additional, significant work beyond typical testing is documented (e.g., extensive consultative report or complex interpretation specific to the PLA). |
52 | Reduced services | Use when the test was partially performed or limited relative to full service (e.g., incomplete panel due to sample insufficiency). |
53 | Discontinued procedure | Use when testing was initiated but discontinued for documented reasons (e.g., unacceptable sample, patient refusal) prior to completion. |
26 | Professional component | Use when the performing laboratory separates and bills the professional interpretation component distinct from technical processing. |
TC | Technical component | Use when billing only the laboratory processing without professional interpretation. |
59 | Distinct procedural service | Use when another distinct laboratory or service is provided the same day and needs separation from the PLA test. |
QW | CLIA waived test | Typically not applicable to LC-MS/MS PLA; include only if specific waived methodology applies (rare). |
91 | Repeat clinical diagnostic laboratory test | Use when the same PLA test is repeated on the same day for valid clinical reasons (e.g., verify unexpected result). |
90 | Reference (outside) laboratory | Use when specimen is forwarded to a reference lab and billing indicates independent lab processing. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207Q00000X | Pain Medicine | Frequent ordering specialty for drug monitoring and toxicity risk assessment. |
208D00000X | Neurology | Manages complex medication regimens where drug interaction risk is relevant. |
207L00000X | Psychiatry & Neurology (Psychiatry) | Behavioral health providers monitor adherence, substance exposure, and interactions. |
207P00000X | Internal Medicine | Primary care physicians ordering comprehensive medication monitoring. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
F11.20 | Opioid dependence, uncomplicated | Indicates opioid use disorder or chronic opioid therapy where drug monitoring and interaction risk assessment with 0587U is clinically relevant. |
F10.20 | Alcohol dependence, uncomplicated | Co-occurring substance use can affect metabolism and toxicity risk assessed by 0587U. |
G89.29 | Other chronic pain | Chronic pain management often requires polypharmacy surveillance; 0587U helps detect concomitant substances and interactions. |
Z79.899 | Other long term (current) drug therapy | Denotes chronic medication use where comprehensive drug panels and interaction risk scores are useful. |
T38.0X5A | Adverse effect of beta-blockers, initial encounter | Example of medication adverse effects context; 0587U can help identify contributing concomitant substances or metabolites. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
80048 | Basic metabolic panel; commonly includes electrolytes and renal function testing | Performed alongside 0587U to assess organ function that affects drug metabolism and toxicity risk. |
81002 | Urinalysis, non-automated, without microscopy | May be performed at collection to assess specimen characteristics prior to sending 0587U. |
80305 | Drug screen, presumptive, any method; multiple drug classes | A presumptive immunoassay screen that may precede confirmatory LC-MS/MS testing such as 0587U. |
G0480 | Therapeutic drug monitoring; incentive for monitoring complex regimens (note: HCPCS) | Used in workflows assessing therapeutic levels and monitoring for toxicity in concert with 0587U. |
36415 | Collection of venous blood by venipuncture | May be performed in the same visit for complementary laboratory tests (e.g., hepatic panels) to interpret 0587U results. |