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OIG audit finds Medicare could have saved up to $ 215.8 million over 5 years. Drug testing is generally performed to detect the presence or absence of drugs in patients undergoing treatment for pain management or substance use disorders. There are two types of drug testing: presumptive and definitive. A presumptive drug test identifies whether drugs […]
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In other words, how would I code for a presumptive or definitive drug test using blood when other specimens (urine, blood, oral fluid, meconium, hair) are not considered medically necessary.
Thanks
Jenny Berkshire, CPC, CPMA, CEMC, CGIC
I understand that when it comes to pathology and diagnosis coding, the provider can wait for the pathology report to come back in order to supply a definitive diagnosis. Likewise, as a coder you can code from the path report.
If Dr. A sees the patient at 9am, and Dr. B performs the EGD at 1pm. The coder doesn’t code the notes until 14 days later (long after the patient has been discharged from the hospital). Can the coder still pull the diagnosis from the EGD report for Dr. A’s claim or would the coder have to report the signs/symptoms for Dr. As claim because technically the patient didnt have a definitive diagnosis at 9am??…If this logic is true, it just seems to contradict the pathology rules.
I’m speaking from the pro-fee inpatient side.