Billing and Coding: Urine Drug Testing

Medicare Part B covers urine drug testing when medical necessity and all coverage criteria in LCD DL34645 are met; urine is the preferred specimen for broad screening, though blood or oral fluid may be used. Providers must place written orders specifying drugs/drug classes and maintain legible medical records that document clinical indications, and billing is limited to one presumptive and one definitive drug test code per patient per day (one unit each); services are payable only in specified outpatient settings and non-covered services generally require an ABN prior to service.

"Urine, blood, or oral fluid specimens may be used for drug testing, with urine preferred for broad screening of common drugs."

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