Part B Coding Coach: Expect 2-Tier Drugs-of-Abuse Reporting for Medicare

Why This Topic Matters

Labs that perform toxicology and drugs-of-abuse testing need to track CMS reporting changes carefully because the proposed 2016 framework would alter how services are grouped, reported, and priced for Medicare payment.

Article Sections

1. Background on CMS drug-testing reporting changes

   Introduces the Medicare drug-testing coding changes and places the proposal in the context of earlier CMS reporting rules and stakeholder feedback.

2. Use 3 codes for screening in 2016

   Summarizes the proposed presumptive testing structure for the 2016 reporting year and the general factors used to distinguish the codes.

3. Count drug classes to pick confirmatory code in 2016

   Explains the proposed tiered structure for confirmatory drug testing and how the categories are organized at a high level.

4. Validation and related laboratory testing

   Covers the article’s discussion of validation testing and related laboratory services mentioned in connection with the new framework.

5. Brace for CMS payment plan

   Reviews the proposed pricing approach and the broader policy concerns raised about the payment methodology.