Wiki Urine/Blood Test on same day

[phammers66]

Does anyone know if there are any issues with having a urine sample sent to a lab and a blood test done the same day sent to another lab?

The tests that are being done are for the purpose of monitoring the patient's medications.

The lab rep for the blood draw is telling me that Medicare is the only insurance that states that the two tests can't be run on the same day. I asked her if she was able to talk to a coder but she skated around the question.

I need some help from some lab test gurus please!!

 

[dwaldman]

Limitations of Coverage:
It is considered not reasonable or necessary to test for the same drug with both a blood and a urine specimen simultaneously.

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Need to review the local coverage determination policy for qualitative drug screens for the Medicare carrier you are billing. Above is an example where a local coverage determination policy addresses both urine and blood specimens. Although this might not be specific to your scenario, you can look at the policy and call back and state from reviewing the policy this is what it states and this is what we are trying to accomplish. Is the lab have additional information on why it can not be down for the scenario that you are requesting. By stating you have pull the policy then they have to provide more justification if goes beyond the policy and based on past denials or other issues.

 

[phammers66]

Thank you. I have suggested that they take the urine sample and do the spot check in the office - not send it to be run through the analyzer or confirmation process - and do the blood draw and use the results from that. Also let the rep know that, if the insurance notices the same codes being billed, they will most likely recoup the money from the lab that is processing the blood (they are out of network) and will let the preferred lab that processed the urine keep the payment made to them.