Billing and Coding: Urine Drug Testing

Urine drug testing must follow the Local Coverage Determination and is covered when medically indicated with a valid ICD-10-CM diagnosis that best describes the reason for testing; for tests requiring an ordering/referring physician, that physician's name and NPI must be included on the claim. Claims lacking a valid ICD-10-CM code will be returned as incomplete, and procedure codes may be adjusted or denied per NCCI and OPPS edits; report diagnostic test results if available or otherwise document the symptoms prompting the test.

"Urine drug testing performed as a diagnostic test or for clinical monitoring when there is a documented medical indication and a valid ICD-10-CM diagnosis code that best describes the patient's con..."

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