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    v1.0.28
    OpenPayerBilling CodesTherapeutic Drug AssaysCPT cpt-80362-targeted-opioid-opiate-toxicology-assay
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    CPT 80362: Opioid/Opiate Analog Detection (One or Two)

    CPT code 80362 describes a clinical laboratory test that measures the amount of or detects the presence of one or two opioids or opiate analogs (narcotic analgesics that depress the central nervous system) in a patient specimen; service type is toxicology/drug testing and the typical site of service is a clinical laboratory or hospital laboratory where specimens are analyzed by a lab analyst using validated qualitative or quantitative methods.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 34-year-old patient on chronic pain management presents for routine urine drug monitoring prior to a scheduled opioid prescription refill. The clinician orders a targeted laboratory test to detect or quantify one or two opioids or opiate analogs in the urine specimen to confirm medication adherence and to screen for non-prescribed opioid use. The specimen is collected at an outpatient collection site and sent to the clinical laboratory. A laboratory analyst performs an appropriate immunoassay or chromatographic method to measure the presence and/or amount of the specified opioids/opiate analogs. Results are reported to the prescribing provider and documented in the electronic health record; where necessary, a confirmatory test (e.g., GC-MS or LC-MS/MS) may follow if initial results are unexpected or require quantitation for clinical decision-making. Typical site of service is an outpatient clinic or hospital outpatient laboratory; the service type is toxicology/opioid drug testing for one or two analytes.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    80305Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes specimen validation when performed, per date of serviceOften performed as a point-of-care presumptive screen before or alongside targeted opioid testing to provide rapid initial results
    80306Drug test(s), presumptive, any number of drug classes; instrumented analyzer, includes specimen validation when performed, per date of serviceInstrumented presumptive screening that may precede a single- or multi-analyte targeted opioid assay
    80307Drug test(s), presumptive, any number of drug classes; multiple devices or procedures, per date of serviceUsed when multiple presumptive methods are used during the same visit prior to targeted testing
    83992Therapeutic drug assay, other (e.g., for non-opioid medications)Used for quantification of non-opioid therapeutic drugs in workflows where multiple medication levels are monitored
    82542Assay of opiates; qualitativeAlternative or complementary code for qualitative detection of opiates when more analytes are included
    80365Drug test confirmation, any number of drug classes; confirmation by quantitative method (e.g., GC-MS, LC-MS/MS)Performed after an unexpected or critical result from initial targeted testing for definitive identification and quantitation

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    2084N0400XNeurology PhysicianA Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, auton…
    163WP0218XPediatric Oncology Registered NurseNursing Service Providers · Registered Nurse
    207PT0002XMedical Toxicology (Emergency Medicine) PhysicianMedical toxicologists are physicians who specialize in the prevention, evaluation, treatment and monitoring of injury and illness from exposures to dr…

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    F11.10Opioid abuse, uncomplicated
    F11.120Opioid abuse with intoxication, uncomplicated
    F11.129Opioid abuse with intoxication, unspecified
    F11.14Opioid abuse with opioid-induced mood disorder
    F11.20Opioid dependence, uncomplicated
    F11.21Opioid dependence, in remission
    F11.220Opioid dependence with intoxication, uncomplicated
    F11.229Opioid dependence with intoxication, unspecified
    F11.24Opioid dependence with opioid-induced mood disorder
    F11.288Opioid dependence with other opioid-induced disorder

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 2

    10 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Chimeric Antigen Receptor (CAR) T-Cell TherapyColorado Rocky Mountain Health Plans2026-08-01
    Allogeneic Hematopoietic Progenitor Cell TherapyAmbetter Georgia2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Idaho Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for New Jersey Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Ohio Only)UnitedHealthcare2026-08-01
    Reblozyl (luspatercept-aamt) Medical Benefit Drug PolicyUnitedHealthcare2026-08-01

    Related Codes

    CPT-80143-ACETAMINOPHEN-QUANTITATIVE-SERUM-ASSAY

    CPT 80143: Acetaminophen Quantitative Assay

    CPT-80145-ADALIMUMAB-LEVEL-ASSAY-THERAPEUTIC-DRUG-MONITORING

    CPT 80145: Adalimumab Quantitative Drug Level Assay

    CPT-80150-AMIKACIN-QUANTITATIVE-ASSAY-THERAPEUTIC-DRUG-MONITORING

    CPT 80150: Amikacin Quantitative Serum Level

    CPT-80151-AMIODARONE-QUANTITATIVE-SERUM-ASSAY

    CPT 80151: Amiodarone Quantitative Drug Level Assay

    CPT-80155-CAFFEINE-LEVEL-TESTING

    CPT 80155: Caffeine Level Quantification

    CPT-80156-CARBAMAZEPINE-TOTAL-LEVEL-LAB-ASSAY

    CPT 80156: Carbamazepine Total Level (Serum)

    CPT-80157-FREE-CARBAMAZEPINE-ASSAY

    CPT 80157: Free Carbamazepine Quantitative Assay

    CPT-80158-CYCLOSPORINE-QUANTITATIVE-ASSAY-LAB

    CPT 80158: Cyclosporine Quantitation, Laboratory

    CPT-80159-CLOZAPINE-LEVEL-ASSAY-THERAPEUTIC-DRUG-MONITORING

    CPT 80159: Clozapine Level Measurement

    CPT-80161-CARBAMAZEPINE-EPOXIDE-QUANTITATIVE-ASSAY

    CPT 80161: Carbamazepine 10,11-Epoxide Level, Quantitative

    Showing 1–10 of 87

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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