decisionhealth Newsletters, Coder Pink Sheets - 2014 Issue 12 (December)
Fee schedule 2015 :The wait continues for Medicare’s decision on new codes and pay for drug screens
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Article Overview
This article reviews late-breaking Medicare activity affecting 2015 reporting and payment for drug screen testing. It focuses on the clinical laboratory fee schedule and the physician fee schedule, explains that the issue involves new and existing code sets for qualitative and quantitative drug testing, and highlights why laboratories, pain-management practices, and billing teams needed to watch for payer guidance.
Why This Topic Matters
Drug testing billing was in transition, with Medicare decisions potentially affecting which code set would be used by different payers and how practices would need to prepare their charge capture, super bills, and software. The article is relevant to organizations that bill for laboratory drug screens, drug assay, and confirmation services.
Article Sections
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Clinical lab fee schedule, 2015 — preliminary determination
Covers Medicare’s proposed-rule activity for the 2015 clinical laboratory fee schedule and the status of public comments and final rule timing. It discusses the broader context of how the agency was approaching payment for drug screen-related services.
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Final 2015 Medicare physician fee schedule
Summarizes the physician fee schedule release and its relationship to drug testing reporting for 2015. It also notes the presence of relevant addendum material and the uncertainty surrounding final payer direction.
What You Will Learn
- How Medicare’s 2015 fee schedule actions affected drug screen reporting topics
- How the article frames the relationship between laboratory and physician fee schedule updates
- Which types of stakeholders needed to monitor payer guidance for drug testing billing changes
- Why the article emphasizes preparation for changes in reporting workflows and systems
Who Should Read This
- Medical coders
- Billing specialists
- Laboratory billing staff
- Pain management practices
- Health care compliance teams
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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