Proposed Drug Testing LCD Limits Use of Panels, Confirmation Testing

Noridian Healthcare Solutions, LLC (NHS) has proposed a new drug testing Local Coverage Determination (LCD that would limit the use of panels of tests and limit confirmatory testing to only positive drug test results. The proposed LCD (DL34754) would apply to Medicare Jurisdiction F. The LCD divides testing into three groups, emergency medical care, addiction medicine, and medical management of patients using chronic opioid therapy. Each group has different goals and different timelines, and the LCD attempts to address each category in the contents of medical necessity. The LCD makes it clear that routine use of preset panels of drugs without any consideration for the patient’s history and clinical indications could be a problem. The LCD states that “clinicians must have choice in selecting which drugs to test and when.” There may be a change in the appearance of drug testing requisitions if the proposed LCD is finalized as written. Any laboratory involved in drug testing should obtain a copy of this LCD and review it as it potentially could be adopted by other Medicare contractors as well.

MAC JF for Arizona, Alaska, Idaho, Oregon, Montana, North Dakota, South Dakota, Utah, Washington, Wyoming