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G043
G043 – Drugs of abuse screen, urine
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
A drugs of abuse screen performed on a urine sample, which must include testing for at least four different drugs. The commentary on clarifies 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. Payment for this service is subject to several conditions outlined in the payment rules on .
When to Use
- Use G043 when performing a urine screen for at least four distinct drug classes in a patient undergoing addiction management or monitoring.
- Select G043 when the clinical documentation confirms the screening of four or more substances, such as cannabinoids, benzodiazepines, opiates, and cocaine, in a single urine sample.
Common Pitfalls
- Billing G043 without a corresponding K623, K624, or a face-to-face assessment code in the same month will result in an automatic rejection.
- Submitting G043 alongside G040, G041, or G042 for the same urine sample is a billing error, as only one of these codes is eligible for payment per specimen.
Billing Tips
- Ensure your clinical note explicitly lists the four or more drugs tested to satisfy the requirement for G043, as this is a common audit trigger.
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