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G042
G042 – Target drug testing, urine, qualitative or quantitative
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
G042 is a target drug test using urine, performed on a qualitative or quantitative basis. It is a test for a specific drug of abuse. The Schedule notes that drugs of abuse may include any of the following: alcohol, methadone, methadone metabolite, morphine, a synthetic or semi-synthetic opiate, cocaine, benzodiazepines, amphetamines, methamphetamines, cannabinoids, barbiturates or any other drug of abuse.
When to Use
- Use G042 when performing a targeted urine screen for a single specific drug class, such as benzodiazepines or cannabinoids, in a patient undergoing opioid agonist maintenance treatment.
- Use G042 for monitoring compliance in chronic pain patients when you need to verify the presence or absence of a specific prescribed opioid or illicit substance.
Common Pitfalls
- Billing G042 in combination with G040, G041, or G043 for the same urine sample will trigger an automatic rejection as only one of these codes is payable per specimen.
- Exceeding the monthly limit of four services when K682 or K683 is billed, or three services when they are not, will result in payment clawbacks.
Billing Tips
- Ensure your clinical notes clearly specify the single drug class being targeted to justify the use of G042 over broader screening codes like G039.
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