Required Documentation For Urine Drug Testing
The document outlines the required documentation for submitting a urine drug test sample to Southwest Labs. It includes steps for providing medical records, encounter notes, rationale for testing, and ensuring compliance with ICD-10-CM codes. Missing documentation must be submitted within 72 hours.
The document covers testing methodologies, billing practices, patient types (Toxicity, Substance Use Disorder, Chronic Opioid Therapy), medical necessity, Medicare/Medicaid coverage, and compliance with CMS, AMA, and insurer guidelines.
Payor Policies for Urine Drug Testing
Policies By State for Urine Drug Testing
Molecular Policies General LCD’s
Provider Education Medical Necessity
Clinical Resources Molecular Testing Sample Pt Scenarios
References
- https://onbaseext.phs.org/PEL/DisplayDocument?ContentID=OB_000000028908
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=34645#:~:text=Presumptive/Qualitative%20Drug%20Testing%20(hereafter%20called%20%22presumptive%22%20UDT)%20-%20Covered%20when
- https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medicaid-comm-plan-reimbursement/UHCCP-Drug-Testing-Policy.pdf#:~:text=Definitive%20urine%20drug%20test%20(UDT)%20reports%20the%20results%20of%20drugs
- https://www.aetna.com/cpb/medical/data/900_999/0965.html#:~:text=This%20Clinical%20Policy%20Bulletin%20addresses%20drug%20testing%20in%20pain%20management
- https://www.molinahealthcare.com/-/media/Molina/PublicWebsite/PDF/Providers/common/Payment-Integrity/PI-Payment-Policy-33-Outpatient-Definitive-Drug-Testing_Medicaid-Medicare.pdf#:~:text=Outpatient%20definitive%20drug%20testing%20is%20considered%20medically%20necessary%20for%20Members
- https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0513_coveragepositioncriteria_drug_test.pdf#:~:text=Drug%20testing%20is%20used%20as%20a%20diagnostic%20and%20therapeutic%20tool
- https://www.bcbsnm.com/content/dam/hcsc/docs/provider/nm/udt_documentation_guidelines.pdf#:~:text=Blue%20Cross%20and%20Blue%20Shield%20of%20New%20Mexico%20(BCBSNM)%20processes
Got questions? Contact us.
- (505) 609-5227
- 1 (855)875-9796 (fax)
- billingteam@southwestlab.com
- 4261 Balloon Park Rd, NE