Does 83992 require prior authorization?

No, 83992 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 83992?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Medical record documentation of history or suspicion of illicit/prescription drug use, documented noncompliance, or high probability of non-adherence.
Record of the preliminary/presumptive (qualitative) test having been performed and its result.
Documentation of a detailed discussion with the member about recent medication and drug use when used to interpret preliminary test results.
Clinical rationale explaining why preliminary test findings are inconsistent with expectations or why drug class–specific assays are needed to identify precise drug(s); note if no reliable preliminary test exists (e.g., synthetic cannabinoids).

Presumptiveurine drug testing (UDT) to verify compliance with treatment, identify undisclosed drug use or abuse, or evaluate aberrant* behavior, is consideredmedically necessary, beginning at the start of treatment, as part of a monitoring program tailored to the unique needs of individuals who are:
Receiving treatment for chronic pain with prescription opioid or other potentially abused medications;or
Undergoing treatment for, or monitoring for relapse of, opioid or other substance use disorder.
Presumptiveurine drug testing is also consideredmedically necessaryfor the following:
To assess an individual when clinical evaluation suggests use of non-prescribed medications or illegal substances;or
On initial entrance into a pain management program or substance use disorder recovery program.

AMBETTER-CP.MP.50 — Drugs of Abuse: Definitive Drug Testing

ANTHEM-CG-LAB-09 — CG-LAB-09 Drug Testing or Screening in the Context of Substance Use Disorder and Chronic Pain

BCBSIL-MED207.154 — Drug Testing in Pain Management and Substance Use Disorder Treatment

BCBSMT-MED207.154 — Drug Testing in Pain Management and Substance Use Disorder Treatment

BCBSNM-MED207.154 — Drug Testing in Pain Management and Substance Use Disorder Treatment

Ask Verity about documentation requirements, denial risks, or coverage in your state.