decisionhealth Newsletters, Coder Pink Sheets - 2015 Issue 1 (January)
New coding guidance – Medicare issues new drug screen codes, sticks with 2014 payments
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Article Overview
This article explains Medicare’s 2015 approach to drug screen and definitive drug testing coding, with emphasis on the split between Medicare reporting and other payer reporting. It covers the general impact of the 2015 CPT updates, Medicare’s creation of replacement HCPCS G codes, and the operational issues these changes create for ordering, billing, reference labs, and electronic systems. The article is aimed at coding professionals, laboratory staff, and practices that bill for quantitative drug testing.
Why This Topic Matters
Drug testing claims were affected by a major split in code sets, creating coordination challenges for laboratories and practices that bill both Medicare and non-Medicare payers. Understanding the article helps readers anticipate workflow, ordering, and systems updates needed to support the 2015 reporting changes.
Article Sections
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Medicare’s 2015 drug testing coding approach
Summarizes the reason Medicare did not fully adopt the newer coding structure and the general direction of its 2015 payment and reporting approach.
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Different code sets, different requirements
Discusses the operational challenges created by using separate code sets for Medicare and other payers, including how the article frames crosswalk and billing concerns.
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Operational impacts for practices and labs
Covers broader workflow considerations for ordering, reference lab coordination, superbills, and electronic record systems when supporting multiple reporting frameworks.
What You Will Learn
- How Medicare’s 2015 drug testing coding approach differed from the updated CPT framework
- Why billing for drug testing required attention to separate reporting systems
- What kinds of practice and laboratory workflows were affected by the coding changes
- How the article frames the administrative impact on ordering and system preparation
Who Should Read This
- Medical coders
- Laboratory billing staff
- Clinical laboratory managers
- Physician practices
- Revenue cycle teams
Codes Discussed
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