Drug Screening Laboratory Tests – CERT Denials for Jun. 2016

Recent claim reviews performed by the Comprehensive Error Rate Testing (CERT) contractor have noted significant error findings for qualitative drug tests and quantitation of drugs screened (therapeutic drug assays and certain chemistry tests).  In most cases, the independent laboratories that performed and billed the services did not submit sufficient documentation to support the medical necessity of the tests in accordance with Medicare regulations. Providers with repeated error findings may be the subject of additional review or educational contacts by WPS GHA for implementation of corrective actions or may be referred to other CMS affiliated contractors.

Source: https://www.wpsgha.com