decisionhealth Newsletters, Coder Pink Sheets - 2015 Issue 2 (February)
Medicare policy: Palmetto rolls out tough new drug screen policy Feb. 15
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Article Overview
This article covers a Palmetto GBA Medicare policy update affecting billing for drug confirmation tests and the related claim-submission requirements described in local coverage articles A53951 and A53948. It is intended for providers, coders, and billing staff who need to understand the policy’s documentation framework, the use of the McKesson Diagnostics Exchange Z-Code ID process, and the alternate short-string reporting approach referenced by the payer.
Why This Topic Matters
The article is relevant because it describes a payer-specific change that can affect claim acceptance and denial risk for drug confirmation testing. It also points readers to related local coverage guidance and a crosswalk resource used in the reporting workflow.
What You Will Learn
- How the Palmetto GBA policy update affects billing for drug confirmation testing.
- What documentation/reporting options are referenced in the local coverage article.
- Which related local coverage resources are associated with the policy.
- How the article frames the claim submission field involved in the policy.
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Clinical laboratory staff
- Practice managers
Codes Discussed
Modifiers Discussed
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