Controlled substance monitoring and drugs of abuse testing – overpayments

First Coast Service Options Inc. has identified an internal processing issue that resulted in overpayments related to specimen validity testing (SVT). SVT is an internal laboratory procedure to determine whether the urine specimen has been diluted or adulterated that also assures and protects the laboratory from reporting invalid test results to the ordering physician. SVT results provide information about the integrity of the urine specimen and does not define/establish criteria for a physician to prescribe/non-prescribe pain medication or dismiss a patient, and as such, is not a separately reimbursable Medicare service. CPT code 81003 (routine urinalysis) and CPT code 82570 (urine creatinine), will both be denied when performed on the same date of service as the qualitative drug test HCPCS codes G6030-G6057 [which were deleted effective January 1, 2016] and G0477-G0483 [effective on and after January 1, 2016]). Providers who received payment in error will receive a demand letter requesting the monies back.

Source: https://medicare.fcso.com