Summary & Overview
CPT 80364: Multi-Opioid Toxicology Panel, Five or More Analytes
CPT code 80364 denotes a comprehensive toxicology panel that measures or detects five or more opioids and opiate analogs in a patient specimen. This code is used for multi-analyte opioid testing across clinical settings where opioid exposure or use must be assessed, including pain management, addiction medicine, emergency departments, and workplace testing. Nationally, accurate coding for multi-opioid panels supports clinical decision-making, utilization tracking, and appropriate laboratory reimbursement for complex assays.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how CPT code 80364 is characterized, common sites of service, and the clinical contexts driving test orders. The publication outlines expected content such as payer coverage patterns, benchmark metrics, and policy or coding guidance where available. It also provides clinical context for when multi-opioid panels are used and what providers and laboratories should document to support medical necessity.
Where input data is missing, this summary notes that specific payer policies, ICD-10 linkages, and related codes were not provided in the source. The material is presented for a national audience and focuses on the code definition, service use, and the types of information readers can expect to find in the full publication.
Billing Code Overview
CPT code 80364 describes a laboratory test in which the analyst measures the amount of, or detects the presence of, five or more opioids and opiate analogs (narcotic analgesics that depress the central nervous system) in a patient specimen. The service type is toxicology testing / multi-analyte opioid panel, performed by clinical laboratory personnel using validated analytical methods.
The typical site of service for CPT code 80364 is a clinical laboratory or other diagnostic testing facility capable of performing comprehensive toxicology panels. This service is commonly ordered by clinicians managing pain treatment, addiction care, emergency medicine, or forensic and workplace testing programs.
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Clinical & Coding Specifications
Clinical Context
A 38-year-old patient presenting to an outpatient pain clinic is undergoing urine drug testing as part of chronic opioid therapy monitoring. The clinician orders a comprehensive urine toxicology panel to detect multiple opioids and opiate analogs to confirm prescribed medication adherence, identify undisclosed opioid use, and assess for potential diversion or unsafe combinations. The specimen is collected under chain-of-custody procedures when indicated. The laboratory performs a multi-analyte immunoassay screen or mass spectrometry panel capable of detecting five or more opioids and opiate analogs; positive or presumptive positive results are reflexed to confirmatory testing by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-tandem mass spectrometry (LC-MS/MS). Typical workflow steps include specimen collection and accessioning, analytical testing, result verification by a credentialed laboratory analyst, and reporting to the ordering clinician. Typical sites of service include hospital outpatient laboratories, independent clinical reference laboratories, pain management clinics with laboratory services, and certified substance abuse treatment centers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting | Use when no special circumstances apply to the service. |