Wiki Drug Testing/Screening Frequency & Documentation

suemt

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Does anyone have info on appropriate/payable frequency for drug testing pain management patients? The statistics are staggering:

11% of specimens test positive for illicit drugs.
29% test positive for other nonprescribed drugs.

Our providers would like to periodically test ALL chronic pain med patients, whether there is indication of abuse/diversion or not, but want to make sure they do it correctly.

Does anyone have an office policy (or feel it would be valid to have one) stating everyone receives a periodic drug screening test whether there is an indication or not? Does anyone have links to insurance, medical or reimbursement policies documenting payments for periodic screening, without cause?

Intuitively it would make sense to say something like, "our office policy is to randomly test all patients at least twice a year." then your medical documentation for that visits test would simply say "in accordance with our office policy, patient XYZ was administered a drug screening test today." however, I know what makes sense is and always what is acceptable.

Thanks in advance for any feedback.
 
Take a look at the Palmetto LCD L35105 Controlled Substance Monitoring and Drugs of Abuse Testing that became effective today. It has a pretty good section on basing the testing frequency on a validated risk assessment and stratification. The frequency then would vary depending upon if the patient is low, moderate or high risk.

Here is a link to the Palmetto J11 home page: http://www.palmettogba.com/palmetto/providers.nsf/DocsCatHome/Jurisdiction 11 Part B The link for the LCDs is on the left under Medical Policies

Some states have regulatory requirements regarding testing frequency that you may want to check into also.
 
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