Wiki Coding for obtaining urine sample, validity testing, presumptive testing and send out drug testing

[lanasanders]

Our clinics have patients presenting for pre-employment urine drug screens as referred by their employers.
MA's obtain a urine sample and perform validity testing. Medical provider does not interact with the patient.
Some sites do a presumptive visual interpretation of NEGATIVE or NON-NEGATIVE. If NON-NEGATIVE, the sample is then sent out for lab company processing
Most sites send out for lab company processing

Can we charge a 99211 for this MA-only visit as we have an employment agreement to perform drug testing even though it isn't part of a specific treatment plan for that patient?

Can we charge 81002 for the urine validity testing if the specimen is then sent out to the lab company for outside drug test processing. (or is that fee still considered part of the bill submitted by the lab company for processing of the definite drug test)

Can we charge 80305 for the presumptive Negative test result that does not have a confirmatory send out test performed by outside lab? (specimen validity testing fees included)

Can we charge 80305 for the presumptive NON-NEGATIVE test result that then requires a send out and definitive test performed by an outside lab company. (specimen validity testing included)

 

[SharonCollachi]

I don't see any E&M service being performed by, or ordered by, a licensed clinician, so no, you don't get a 99211.

The use of 80305 is not dependent on the result of the test.

I'm not seeing an 81002 (which is for urinalysis, not drug testing).

I think the bigger question is, who are you billing?? If you have a program where employers send their candidates to you (by the way, in many states, that would have to be after they have the job offer), then the employers are paying a fee directly to you for that service. There should be a flat rate, make up your own code such as PEUDS (pre-employment urine drug screening) and charge the employers. If any come back from the lab positive for illicit substances, then the MD gets involved to interpret the results, talk to the employer and candidate, and there is a second charge for that, to the employer, such as UDSPOS (urine drug screen positive).

The lab would also be billing the employer for their services.

I worked for a while in family practice in a rural area, and we did this all the time for the surrounding farms. Some paid on a per-candidate basis, and some just paid a monthly flat rate no matter how many times they used us.