HCPro, JustCoding Outpatient - 2018 Issue 21 (May)
Medicare reissues guidance on specimen validity testing for drug screening
May 18th, 2018
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Article Overview
This article covers Medicare guidance on specimen validity testing when it is performed alongside urine drug testing, along with the surrounding reimbursement and billing context. It is intended for coders, laboratories, and other providers who bill drug testing services and need a clearer view of the CMS and OIG-related guidance discussed in the article. The piece also reviews the general categories of presumptive and definitive drug testing and the coding structures referenced in the guidance.
Why This Topic Matters
The topic matters because it addresses a common compliance and payment issue in urine drug testing billing. Understanding the guidance helps providers and coders distinguish between services discussed in the article and review the Medicare coding framework referenced by CMS.
Article Sections
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Overview of the Medicare guidance and OIG findings
Introduces the CMS guidance and the related Inspector General report discussed in the article. Summarizes the compliance and payment context for specimen validity testing in urine drug screening.
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What is specimen validity?
Describes specimen validity testing in broad terms and explains the types of specimen alteration addressed in the article. Also discusses why urine drug screening may be used in certain monitoring settings.
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Coding for presumptive and definitive drug testing
Reviews the coding framework referenced for presumptive and definitive urine drug testing. Covers the code sets, grouped coding structure, and Medicare-related guidance discussed by the author.
What You Will Learn
- How the article frames Medicare guidance on specimen validity testing
- How the article distinguishes broad categories of urine drug testing
- Which code sets are referenced in the discussion of drug testing billing
- What organizations and reports are central to the guidance discussed
Who Should Read This
- Medical coders
- Billing staff
- Laboratory professionals
- Compliance staff
- Physician practice managers
Codes Discussed
Code Ranges Discussed
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