Wiki Referring/Ordering Provider for Qual Drug Screening

[suemt]

Does anyone know where I can get clarification on who may order these tests?

 

[dwaldman]

Need check in the state you are in if they have active or draft policy/local coverage determination for drug testing for the Medicare carriers. The Medicaid carriers might also have policy due to the high cost to the carrier to reimburse the more complex tests for ongoing chronic opioid management. The physician is described below they don't describe the non-physician provider or other qualified health care professional in the wording.

An order furnished by the physician and signed/dated/timed would be required for all diagnostic lab testing. This requirement can also be found in the CMS internet only manual.

http://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=34676&ContrId=148


The terms ?drug screening? and ?drug testing? are somewhat misleading because they may be interpreted that all drugs will be identified by ordered test panels. In reality, the drug or drug metabolites detected by a test depend on the testing method and the device or test method cutoff concentrations. In the clinical care of patients, the need for testing each drug ordered must be documented and the connection between the test order and clinical decision-making following test results must be reasonable and medically necessary to the ongoing care of the patient.

Documentation
A signed and dated physician order for clinical drug screening and/or testing is a key element the medical record and the clinical decision-making based thereon. Documentation is important to the billing and claims for reimbursement of clinical laboratory services. Copies of the test results alone without a proper clinician order for the test are not sufficient documentation to support a claim for the testing services.

The physician order must specifically match the number, level, and complexity of the testing panel components performed. Orders for ?custom profiles?, ?standing orders? or ?orders to conduct additional testing as needed? are typically not sufficiently detailed and thus cannot be used to verify the medical necessity for the specific tests the ordering clinician intended to be performed.