Navigating New CMS Billing Edits for Drug Testing

On July 1, CMS implemented a new billing edit code that is having a substantial impact on the operations of drug testing laboratories serving Medicare Part-B patients nationwide. This new NCCI prepayment edit results in claims for definitive drug testing being automatically denied when billed on the same claim with presumptive tests. This procedure-to-procedure edit impacts codes 80305, 80306, and 80307 for presumptive drug testing, and codes G0480-G0483 and G0659 for definitive testing.

Given this dramatic shift, how can toxicology labs and pain management providers best respond in order to minimize impacts to their patients and overall operations? During this webinar, our experts will break down what's driving the implementation of this edit and will offer steps for navigating these changes to keep your revenue cycle healthy.

We'll also review:

-Potential revisions of the edit by CMS.
-Compliant steps labs can pursue when billing for these services.
-Appropriate modifiers usage.
-A review of the overall payment landscape and advocacy steps labs can take to push back against burdensome regulations.