Avoid specimen validity, drug screen codes on same day except in rare cases

Why This Topic Matters

The topic matters because these claims have been targeted in audits and edits, and incorrect reporting can lead to denials or improper payments. Understanding the scope of the guidance helps organizations reduce compliance risk and review payer-specific policies.

Article Sections

1. CMS and OIG guidance on specimen validity testing

   Introduces the compliance concern, the role of CMS and OIG, and the overall billing issue involving urine drug screening and specimen validity testing.

2. When same-day reporting may be considered

   Describes the narrow circumstances in which specimen-related testing may be viewed as part of a separate diagnostic service rather than only a drug-screening service.

3. Examples and payer policy considerations

   Provides a general illustration of documentation context and notes the importance of local Medicare coverage policy and contractor-level review.