Drug Testing

Policy ID: L-102-027

Section: Laboratory

Effective Date: July 01, 2018

Revised Date: December 18, 2020

Revision Effective Date: January 01, 2021

Last Reviewed: January 19, 2021

Description

Individuals in pain management and substance abuse treatment programs may misuse prescribed opioids and/or may use non-prescribed drugs. Therefore,individuals in these settings are often assessed before treatment and monitored while they are receiving treatment. Drug screening is one monitoring strategy; it is most often used as part of a multifaceted intervention that includes other components such as individualcontracts.

Presumptive (i.e., qualitative, immunoassay) tests are usually performed at the point of service (POS). Immunoassay tests are based on the principle of competitive binding and use antibodies to detect a particular drug or drug metabolite in a sample.

Definitive (i.e., confirmatory, quantitative) tests are always performed in a laboratory and assess multiple drugs at one time. Individual tests are specific to one drug only. Definitive testing is a panel that includes individual drug tests and the associated levels of the specific drugs. Definitive drug testing is more cost effective than individual testing. Gas chromatography/mass spectrometry (GC/MS) is considered to be the gold standard for confirmatory testing

Procedure codes for medically necessary tests within this policy do not require pre-authorization.

Criteria

Routine presumptive urine drug testing in substance use disorder treatment (i.e., testing at every visit or without consideration for specific individual risk factors) is considered not medically necessary.

Procedure Codes

80305

80306

80307

Specimen validation testing is inherent to presumptive and confirmatory testing and is considered not medically necessary.

Procedure Codes

82542

82570

83986

84311

84315

Definitive (i.e., confirmatory, quantitative) drug testing may be considered medically necessary under ANY ONE of the following conditions:

When performed as a reflex by a Clinical Laboratory Improvement Amendments (CLIA) certified laboratory after a positive presumptive test when ANY ONE of the following are met:
- To verify a presumptive positive urine drug test before reporting the presumptive finding to the ordering clinician and without an additional order from the clinician; or
- In specific situations for which definitive testing is required for clinical decision making and would significantly change a treatment plan (e.g., to distinguish drug supplementation from products of minor metabolic pathways; to help identify patients diverting medications); or
- To identify non-prescribed medication or illicit substance use so as to allow safe prescribing of controlled substances, where the clinician has documented concerns related to safety risks that may arise due to failure to identify non-prescribed medications or illicit substances; or
When presumptive drug tests are not available for the drug(s) for which there is a suspicion of abuse or misuse and ALL of the following criteria are met:
- The clinical presentation of the individual being testing supports the need for the specific drug testing being requested; and
- Results of testing will impact treatment; and
- Testing is performed in a CLIA certified laboratory.

Definitive and presumptive drug testing is considered not medically necessary when the above criteria are not met.

Procedure Codes

80375	80376	80377	G0480	G0481	G0482	G0483
G0659

Limitations

Presumptive drug testing may be considered medically necessary and will only be allowed one (1) per date of service regardless of the number of drug classes tested.

Quantity level limits (QLLs) are considered not medically necessary when the frequency guidelines listed above are exceeded.

Procedure Codes

80305

80306

80307

Definitive drug testing, when billed in any combination, may be considered medically necessary and will be allowed one (1) service per date with a limit of 24 tests per benefit period.

QLLs are considered not medically necessary when the frequency guidelines listed above are exceeded.

Procedure Codes

80375	80376	80377	G0480	G0481	G0482	G0483
G0659

Individual drug tests are considered not medically necessary.

Procedure Codes

80320	80321	80322	80323	80324	80325	80326
80327	80328	80332	80333	80334	80335	80336
80337	80338	80345	80346	80347	80348	80349
80350	80351	80352	80353	80354	80355	80356
80357	80358	80359	80360	80361	80362	80363
80364	80365	80366	80367	80368	80369	80370
80371	80372	80373	80374	83992

The following drug tests are considered experimental/investigational, and therefore, non-covered because the safety and/or effectiveness of this service cannot be established by the available published peer-reviewed literature:

Hair drug testing; and
Oral fluid drug testing; and
Meconium drug testing

Procedure Codes

0006U

0007U

0011U

0051U

0054U

0082U

0227U

The collection date of the specimen must equal the date of service for the drugs tested.

Benefit year limits do not apply to the following:

Emergency room visits
Inpatient admissions
Federally regulated testing

The following tests are considered non-covered:

Non-forensic testing (i.e. job related testing)
State/legally mandated drug testing

Diagnosis Codes

Covered Diagnosis Codes for Procedure code 80305, 80306, 80307, 80375, 80376, 80377, G0480, G0481, G0482, G0483 and G0659 (48 services per benefit year)

F10.10	F10.120	F10.121	F10.129	F10.130	F10.131	F10.132
F10.139	F10.150	F10.151	F10.159	F10.180	F10.181	F10.182
F10.188	F10.20	F10.21	F10.220	F10.221	F10.229	F10.230
F10.231	F10.232	F10.239	F10.24	F10.250	F10.251	F10.259
F10.26	F10.27	F10.280	F10.281	F10.282	F10.288	F10.29
F10.920	F10.921	F10.929	F10.930	F10.931	F10.932	F10.939
F10.94	F10.950	F10.951	F10.959	F10.96	F10.97	F10.980
F10.981	F10.982	F10.988	F10.99	F11.10	F11.11	F11.13
F11.14	F11.19	F11.20	F11.21	F11.23	F11.24	F11.29
F11.90	F11.93	F11.94	F11.120	F11.121	F11.122	F11.129
F11.150	F11.151	F11.159	F11.181	F11.182	F11.188	F11.220
F11.221	F11.222	F11.229	F11.250	F11.251	F11.259	F11.281
F11.282	F11.288	F11.920	F11.921	F11.922	F11.929	F11.950
F11.951	F11.959	F11.981	F11.982	F11.988	F12.10	F12.120
F12.121	F12.122	F12.129	F12.13	F12.150	F12.151	F12.159
F12.180	F12.188	F12.19	F12.20	F12.21	F12.220	F12.221
F12.222	F12.229	F12.250	F12.251	F12.259	F12.280	F12.288
F12.29	F12.90	F12.920	F12.921	F12.922	F12.929	F12.950
F12.951	F12.959	F12.980	F12.988	F12.99	F13.10	F13.120
F13.121	F13.129	F13.130	F13.131	F13.132	F13.139	F13.14
F13.150	F13.151	F13.159	F13.180	F13.181	F13.182	F13.188
F13.19	F13.20	F13.21	F13.220	F13.221	F13.229	F13.230
F13.231	F13.232	F13.239	F13.24	F13.250	F13.251	F13.259
F13.26	F13.27	F13.280	F13.281	F13.282	F13.288	F13.29
F13.90	F13.920	F13.921	F13.929	F13.930	F13.931	F13.950
F13.951	F13.959	F13.96	F13.97	F13.980	F13.981	F13.982
F13.988	F13.99	F14.10	F14.13	F14.14	F14.19	F14.20
F14.21	F14.23	F14.24	F14.29	F14.90	F14.93	F14.94
F14.99	F14.120	F14.121	F14.122	F14.129	F14.150	F14.151
F14.159	F14.180	F14.181	F14.182	F14.188	F14.220	F14.221
F14.222	F14.229	F14.250	F14.251	F14.259	F14.280	F14.281
F14.282	F14.288	F14.920	F14.921	F14.922	F14.929	F14.950
F14.951	F14.959	F14.980	F14.981	F14.982	F14.988	F15.10
F15.120	F15.121	F15.122	F15.129	F15.13	F15.150	F15.151
F15.159	F15.180	F15.181	F15.182	F15.188	F15.19	F15.20
F15.21	F15.220	F15.221	F15.222	F15.229	F15.23	F15.24
F15.250	F15.251	F15.259	F15.280	F15.281	F15.282	F15.288
F15.29	F15.90	F15.920	F15.921	F15.922	F15.929	F15.93
F15.94	F15.950	F15.951	F15.959	F15.980	F15.981	F15.982
F15.988	F15.99	F16.10	F16.14	F16.19	F16.20	F16.21
F16.24	F16.29	F16.90	F16.94	F16.99	F16.120	F16.121
F16.122	F16.129	F16.150	F16.151	F16.159	F16.180	F16.183
F16.188	F16.220	F16.221	F16.229	F16.250	F16.251	F16.259
F16.280	F16.283	F16.288	F16.920	F16.921	F16.929	F16.950
F16.951	F16.959	F16.980	F16.983	F16.988	F18.10	F18.11
F18.120	F18.121	F18.129	F18.14	F18.150	F18.151	F18.159
F18.17	F18.180	F18.188	F18.19	F18.20	F18.21	F18.220
F18.221	F18.229	F18.24	F18.250	F18.251	F18.259	F18.27
F18.280	F18.288	F18.29	F18.90	F18.920	F18.921	F18.929
F18.94	F18.950	F18.951	F18.959	F18.97	F18.99	F19.10
F19.120	F19.121	F19.122	F19.129	F19.130	F19.131	F19.132
F19.139	F19.14	F19.150	F19.151	F19.159	F19.16	F19.17
F19.180	F19.181	F19.182	F19.188	F19.220	F19.221	F19.222
F19.229	F19.230	F19.231	F19.232	F19.239	F19.24	F19.250
F19.251	F19.259	F19.26	F19.27	F19.280	F19.281	F19.282
F19.288	F19.29	F19.90	F19.920	F19.921	F19.922	F19.929
F19.930	F19.931	F19.932	F19.939	F19.94	F19.950	F19.951
F19.959	F19.96	F19.97	F19.980	F19.981	F19.988	F19.99
F45.42	G89.4	G89.21	G89.22	G89.28	G89.29	O99.320
O99.321	O99.322	O99.323	O99.324	Z51.81	Z76.0	Z79.891
Z79.899

Non-Covered Diagnosis Codes for Procedure Codes 80320, 80321, 80322, 80323, 80324, 80325, 80326, 80327, 80328, 80332, 80333, 80334, 80335, 80336, 80337, 80338, 80345, 80346, 80347, 80348, 80349, 80350, 80351, 80352, 80353, 80354, 80355, 80356, 80357, 80358, 80359, 80360, 80361, 80362, 80363, 80364, 80365, 80366, 80367, 80368, 80369, 80370, 80371, 80372, 80373, 80374, 83992)

F10.10	F10.120	F10.121	F10.129	F10.130	F10.131	F10.132
F10.139	F10.150	F10.151	F10.159	F10.180	F10.181	F10.182
F10.188	F10.20	F10.21	F10.220	F10.221	F10.229	F10.230
F10.231	F10.232	F10.239	F10.24	F10.250	F10.251	F10.259
F10.26	F10.27	F10.280	F10.281	F10.282	F10.288	F10.29
F10.920	F10.921	F10.929	F10.930	F10.931	F10.932	F10.939
F10.94	F10.950	F10.951	F10.959	F10.96	F10.97	F10.980
F10.981	F10.982	F10.988	F10.99	F11.10	F11.11	F11.13
F11.14	F11.19	F11.20	F11.21	F11.23	F11.24	F11.29
F11.90	F11.93	F11.94	F11.120	F11.121	F11.122	F11.129
F11.150	F11.151	F11.159	F11.181	F11.182	F11.188	F11.220
F11.221	F11.222	F11.229	F11.250	F11.251	F11.259	F11.281
F11.282	F11.288	F11.920	F11.921	F11.922	F11.929	F11.950
F11.951	F11.959	F11.981	F11.982	F11.988	F12.10	F12.120
F12.121	F12.122	F12.129	F12.13	F12.150	F12.151	F12.159
F12.180	F12.188	F12.19	F12.20	F12.21	F12.220	F12.221
F12.222	F12.229	F12.250	F12.251	F12.259	F12.280	F12.288
F12.29	F12.90	F12.920	F12.921	F12.922	F12.929	F12.950
F12.951	F12.959	F12.980	F12.988	F12.99	F13.10	F13.120
F13.121	F13.129	F13.130	F13.131	F13.132	F13.139	F13.14
F13.150	F13.151	F13.159	F13.180	F13.181	F13.182	F13.188
F13.19	F13.20	F13.21	F13.220	F13.221	F13.229	F13.230
F13.231	F13.232	F13.239	F13.24	F13.250	F13.251	F13.259
F13.26	F13.27	F13.280	F13.281	F13.282	F13.288	F13.29
F13.90	F13.920	F13.921	F13.929	F13.930	F13.931	F13.950
F13.951	F13.959	F13.96	F13.97	F13.980	F13.981	F13.982
F13.988	F13.99	F14.10	F14.13	F14.14	F14.19	F14.20
F14.21	F14.23	F14.24	F14.29	F14.90	F14.93	F14.94
F14.99	F14.120	F14.121	F14.122	F14.129	F14.150	F14.151
F14.159	F14.180	F14.181	F14.182	F14.188	F14.220	F14.221
F14.222	F14.229	F14.250	F14.251	F14.259	F14.280	F14.281
F14.282	F14.288	F14.920	F14.921	F14.922	F14.929	F14.950
F14.951	F14.959	F14.980	F14.981	F14.982	F14.988	F15.10
F15.120	F15.121	F15.122	F15.129	F15.13	F15.150	F15.151
F15.159	F15.180	F15.181	F15.182	F15.188	F15.19	F15.20
F15.21	F15.220	F15.221	F15.222	F15.229	F15.23	F15.24
F15.250	F15.251	F15.259	F15.280	F15.281	F15.282	F15.288
F15.29	F15.90	F15.920	F15.921	F15.922	F15.929	F15.93
F15.94	F15.950	F15.951	F15.959	F15.980	F15.981	F15.982
F15.988	F15.99	F16.10	F16.14	F16.19	F16.20	F16.21
F16.24	F16.29	F16.90	F16.94	F16.99	F16.120	F16.121
F16.122	F16.129	F16.150	F16.151	F16.159	F16.180	F16.183
F16.188	F16.220	F16.221	F16.229	F16.250	F16.251	F16.259
F16.280	F16.283	F16.288	F16.920	F16.921	F16.929	F16.950
F16.951	F16.959	F16.980	F16.983	F16.988	F18.10	F18.11
F18.120	F18.121	F18.129	F18.14	F18.150	F18.151	F18.159
F18.17	F18.180	F18.188	F18.19	F18.20	F18.21	F18.220
F18.221	F18.229	F18.24	F18.250	F18.251	F18.259	F18.27
F18.280	F18.288	F18.29	F18.90	F18.920	F18.921	F18.929
F18.94	F18.950	F18.951	F18.959	F18.97	F18.99	F19.10
F19.120	F19.121	F19.122	F19.129	F19.130	F19.131	F19.132
F19.139	F19.14	F19.150	F19.151	F19.159	F19.16	F19.17
F19.180	F19.181	F19.182	F19.188	F19.220	F19.221	F19.222
F19.229	F19.230	F19.231	F19.232	F19.239	F19.24	F19.250
F19.251	F19.259	F19.26	F19.27	F19.280	F19.281	F19.282
F19.288	F19.29	F19.90	F19.920	F19.921	F19.922	F19.929
F19.930	F19.931	F19.932	F19.939	F19.94	F19.950	F19.951
F19.959	F19.96	F19.97	F19.980	F19.981	F19.988	F19.99
F45.42	G89.4	G89.21	G89.22	G89.28	G89.29	O99.320
O99.321	O99.322	O99.323	O99.324	Z51.81	Z76.0	Z79.891
Z79.899

Professional Statements and Societal Positions

42 CFR 8.12 - Federal opioid treatment standards 2017 An Opioid Treatment Programs (OTPs) organizational structure and facilities shall be adequate to ensure quality individual care and to meet the requirements of all pertinent Federal, State, and local laws and regulations. At a minimum, each OTP shall formally designate a program sponsor and medical director. The program sponsor shall agree on behalf of the OTP to adhere to all requirements set forth in this part and any regulations regarding the use of opioid agonist treatment medications in the treatment of opioid use disorder which may be promulgated in the future. The medical director shall assume responsibility for administering all medical services performed by the OTP. In addition, the medical director shall be responsible for ensuring that the OTP is in compliance with all applicable Federal, State, and local laws and regulations.

Centers for Disease Control and Prevention (CDC) 2016

When prescribing opioids for chronic pain, clinicians should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.

The guideline is intended to improve communication between clinicians and individuals about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder, overdose, and death.

Substance Abuse and Mental Health Service Administration (SAMHSA) 2015 Medication-Assisted Treatment (MAT) is the use of medications, in combination with counseling and behavioral therapies, to provide a whole-individual approach to the treatment of substance use disorders. Research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery.

Federal legislation, regulations, and guidelines govern MAT for opioid addiction. SAMHSA's Division of Pharmacologic Therapies (DPT), part of the SAMHSA Center for Substance Abuse Treatment (CSAT), oversees accreditation standards and certification processes for OTPs. DPT also works with the Drug Enforcement Administration (DEA) and the states to regulate certain medications used in MAT. Additionally, DPT works directly with MAT professionals to improve treatment outcomes and to meet regulatory criteria.

American Society of Addiction Medicine (ASAM) 2017

Appropriate Use of Drug Testing in Clinical Addiction Medicine was published by ASAM in 2017.

"As a general principle, drug testing should be scheduled more frequently at the beginning of treatment. The Expert Panel recommends that an individual in early recovery be tested at least weekly. As the individual becomes more stable in recovery, the frequency of drug testing should be decreased, but performed at least on a monthly basis. Individual consideration may be given for less frequent testing if an individual is in stable recovery. If the individual returns to substance use after a period of abstinence, the provider should resume the early recovery testing schedule, possibly in conjunction with an adapted or intensified treatment plan."

ND Committee Review

Internal Medical Policy Committee 9-21-2020 - Coding update:
- Added Covered Diagnosis codes for Procedure Code 80305, 80306, 80307, 80375, 80376, 80377, G0480, G0481, G0482, G0483 and G0659 (48 services per benefit year): F10.130; F10.131; F10.132; F10.139; F10.930; F10.931; F10.932; F10.939; F11.13; F12.13; F13.130; F13.131; F13.132; F13.139; F14.13; F14.93; F15.13; F19.130; F19.131; F19.132; and F13.139
- Added for Non-Covered Diagnosis Codes for Procedure Codes 80320, 80321, 80322, 80323, 80324, 80325, 80326, 80327, 80328, 80332, 80333, 80334, 80335, 80336, 80337, 80338, 80345, 80346, 80347, 80348, 80349, 80350, 80351, 80352, 80353, 80354, 80355, 80356, 80357, 80358, 80359, 80360, 80361, 80362, 80363, 80364, 80365, 80366, 80367, 80368, 80369, 80370, 80371, 80372, 80373, 80374, 83992:F10.130; F10.131; F10.132; F10.139; F10.930; F10.931; F10.932; F10.939; F11.13; F12.13; F13.130; F13.131; F13.132; F13.139; F14.13; F14.93; F15.13; F19.130; F19.131; F19.132 and F19.139.
Internal Medical Policy Committee 11-19-20 - no changes made-annual review.
Internal Medical Policy Committee 01-19-21 Coding update; New Code 0027U

Links

References (PDF)

Disclaimer

Current medical policy is to be used in determining a Member's contract benefits on the date that services are rendered. Contract language, including definitions and specific inclusions/exclusions, as well as state and federal law, must be considered in determining eligibility for coverage. Members must consult their applicable benefit plans or contact a Member Services representative for specific coverage information. Likewise, medical policy, which addresses the issue(s) in any specific case, should be considered before utilizing medical opinion in adjudication. Medical technology is constantly evolving and the Company reserves the right to review and update medical policy periodically.

Policy ID: L-102-026

Section: Laboratory

Effective Date: July 01, 2018

Revised Date: September 30, 2020

Revision Effective Date: November 02, 2020

Last Reviewed: November 19, 2020

Archived Date: December 31, 2020

Description

Individuals in pain management and substance abuse treatment programs may misuse prescribed opioids and/or may use non-prescribed drugs. Therefore, individuals in these settings are often assessed before treatment and monitored while they are receiving treatment. Drug screening is one monitoring strategy; it is most often used as part of a multifaceted intervention that includes other components such as individual contracts.

Procedure codes for medically necessary tests within this policy do not require pre-authorization.

Criteria

Procedure Code

80305

80306

80307

Specimen validation testing is inherent to presumptive and confirmatory testing and is considered not medically necessary.

Procedure Codes

82542

82570

83986

84311

84315

Definitive (i.e., confirmatory, quantitative) drug testing may be considered medically necessary under ANY ONE of the following conditions:

When performed as a reflex by a Clinical Laboratory Improvement Amendments (CLIA) certified laboratory after a positive presumptive test when ANY ONE of the following are met:
- To verify a presumptive positive urine drug test before reporting the presumptive finding to the ordering clinician and without an additional order from the clinician; or
- In specific situations for which definitive testing is required for clinical decision making and would significantly change a treatment plan (e.g., to distinguish drug supplementation from products of minor metabolic pathways; to help identify patients diverting medications); or
- To identify non-prescribed medication or illicit substance use so as to allow safe prescribing of controlled substances, where the clinician has documented concerns related to safety risks that may arise due to failure to identify non-prescribed medications or illicit substances; or
When presumptive drug tests are not available for the drug(s) for which there is a suspicion of abuse or misuse and ALL of the following criteria are met:
- The clinical presentation of the individual being testing supports the need for the specific drug testing being requested; and
- Results of testing will impact treatment; and
- Testing is performed in a CLIA certified laboratory.

Definitive and presumptive drug testing is considered not medically necessary when the above criteria are not met.

Procedure Codes

80375	80376	80377	G0480	G0481	G0482	G0483
G0659

Limitations

Presumptive drug testing may be considered medically necessary and will only be allowed one (1) per date of service regardless of the number of drug classes tested.

Quantity level limits (QLLs) are considered not medically necessary when the frequency guidelines listed above are exceeded.

Procedure Codes

80305

80306

80307

Definitive drug testing, when billed in any combination, may be considered medically necessary and will be allowed one (1) service per date with a limit of 24 tests per benefit period.

QLLs are considered not medically necessary when the frequency guidelines listed above are exceeded.

Procedure Codes

80375	80376	80377	G0480	G0481	G0482	G0483
G0659

Individual drug tests are considered not medically necessary.

Procedure Codes

80320	80321	80322	80323	80324	80325	80326
80327	80328	80332	80333	80334	80335	80336
80337	80338	80345	80346	80347	80348	80349
80350	80351	80352	80353	80354	80355	80356
80357	80358	80359	80360	80361	80362	80363
80364	80365	80366	80367	80368	80369	80370
80371	80372	80373	80374	83992

Hair drug testing; and
Oral fluid drug testing; and
Meconium drug testing

Procedure Codes

0006U

0007U

0011U

0051U

0054U

0082U

The collection date of the specimen must equal the date of service for the drugs tested.

Benefit year limits do not apply to the following:

Emergency room visits
Inpatient admissions
Federally regulated testing

The following tests are considered non-covered:

Non-forensic testing (i.e. job related testing)
State/legally mandated drug testing

Diagnosis Codes

Covered Diagnosis Codes for Procedure code 80305, 80306, 80307, 80375, 80376, 80377, G0480, G0481, G0482, G0483 and G0659 (48 services per benefit year)

F10.10	F10.120	F10.121	F10.129	F10.130	F10.131	F10.132
F10.139	F10.150	F10.151	F10.159	F10.180	F10.181	F10.182
F10.188	F10.20	F10.21	F10.220	F10.221	F10.229	F10.230
F10.231	F10.232	F10.239	F10.24	F10.250	F10.251	F10.259
F10.26	F10.27	F10.280	F10.281	F10.282	F10.288	F10.29
F10.920	F10.921	F10.929	F10.930	F10.931	F10.932	F10.939
F10.94	F10.950	F10.951	F10.959	F10.96	F10.97	F10.980
F10.981	F10.982	F10.988	F10.99	F11.10	F11.11	F11.13
F11.14	F11.19	F11.20	F11.21	F11.23	F11.24	F11.29
F11.90	F11.93	F11.94	F11.120	F11.121	F11.122	F11.129
F11.150	F11.151	F11.159	F11.181	F11.182	F11.188	F11.220
F11.221	F11.222	F11.229	F11.250	F11.251	F11.259	F11.281
F11.282	F11.288	F11.920	F11.921	F11.922	F11.929	F11.950
F11.951	F11.959	F11.981	F11.982	F11.988	F12.10	F12.120
F12.121	F12.122	F12.129	F12.13	F12.150	F12.151	F12.159
F12.180	F12.188	F12.19	F12.20	F12.21	F12.220	F12.221
F12.222	F12.229	F12.250	F12.251	F12.259	F12.280	F12.288
F12.29	F12.90	F12.920	F12.921	F12.922	F12.929	F12.950
F12.951	F12.959	F12.980	F12.988	F12.99	F13.10	F13.120
F13.121	F13.129	F13.130	F13.131	F13.132	F13.139	F13.14
F13.150	F13.151	F13.159	F13.180	F13.181	F13.182	F13.188
F13.19	F13.20	F13.21	F13.220	F13.221	F13.229	F13.230
F13.231	F13.232	F13.239	F13.24	F13.250	F13.251	F13.259
F13.26	F13.27	F13.280	F13.281	F13.282	F13.288	F13.29
F13.90	F13.920	F13.921	F13.929	F13.930	F13.931	F13.950
F13.951	F13.959	F13.96	F13.97	F13.980	F13.981	F13.982
F13.988	F13.99	F14.10	F14.13	F14.14	F14.19	F14.20
F14.21	F14.23	F14.24	F14.29	F14.90	F14.93	F14.94
F14.99	F14.120	F14.121	F14.122	F14.129	F14.150	F14.151
F14.159	F14.180	F14.181	F14.182	F14.188	F14.220	F14.221
F14.222	F14.229	F14.250	F14.251	F14.259	F14.280	F14.281
F14.282	F14.288	F14.920	F14.921	F14.922	F14.929	F14.950
F14.951	F14.959	F14.980	F14.981	F14.982	F14.988	F15.10
F15.120	F15.121	F15.122	F15.129	F15.13	F15.150	F15.151
F15.159	F15.180	F15.181	F15.182	F15.188	F15.19	F15.20
F15.21	F15.220	F15.221	F15.222	F15.229	F15.23	F15.24
F15.250	F15.251	F15.259	F15.280	F15.281	F15.282	F15.288
F15.29	F15.90	F15.920	F15.921	F15.922	F15.929	F15.93
F15.94	F15.950	F15.951	F15.959	F15.980	F15.981	F15.982
F15.988	F15.99	F16.10	F16.14	F16.19	F16.20	F16.21
F16.24	F16.29	F16.90	F16.94	F16.99	F16.120	F16.121
F16.122	F16.129	F16.150	F16.151	F16.159	F16.180	F16.183
F16.188	F16.220	F16.221	F16.229	F16.250	F16.251	F16.259
F16.280	F16.283	F16.288	F16.920	F16.921	F16.929	F16.950
F16.951	F16.959	F16.980	F16.983	F16.988	F18.10	F18.11
F18.120	F18.121	F18.129	F18.14	F18.150	F18.151	F18.159
F18.17	F18.180	F18.188	F18.19	F18.20	F18.21	F18.220
F18.221	F18.229	F18.24	F18.250	F18.251	F18.259	F18.27
F18.280	F18.288	F18.29	F18.90	F18.920	F18.921	F18.929
F18.94	F18.950	F18.951	F18.959	F18.97	F18.99	F19.10
F19.120	F19.121	F19.122	F19.129	F19.130	F19.131	F19.132
F19.139	F19.14	F19.150	F19.151	F19.159	F19.16	F19.17
F19.180	F19.181	F19.182	F19.188	F19.220	F19.221	F19.222
F19.229	F19.230	F19.231	F19.232	F19.239	F19.24	F19.250
F19.251	F19.259	F19.26	F19.27	F19.280	F19.281	F19.282
F19.288	F19.29	F19.90	F19.920	F19.921	F19.922	F19.929
F19.930	F19.931	F19.932	F19.939	F19.94	F19.950	F19.951
F19.959	F19.96	F19.97	F19.980	F19.981	F19.988	F19.99
F45.42	G89.4	G89.21	G89.22	G89.28	G89.29	O99.320
O99.321	O99.322	O99.323	O99.324	Z51.81	Z76.0	Z79.891
Z79.899

F10.10	F10.120	F10.121	F10.129	F10.130	F10.131	F10.132
F10.139	F10.150	F10.151	F10.159	F10.180	F10.181	F10.182
F10.188	F10.20	F10.21	F10.220	F10.221	F10.229	F10.230
F10.231	F10.232	F10.239	F10.24	F10.250	F10.251	F10.259
F10.26	F10.27	F10.280	F10.281	F10.282	F10.288	F10.29
F10.920	F10.921	F10.929	F10.930	F10.931	F10.932	F10.939
F10.94	F10.950	F10.951	F10.959	F10.96	F10.97	F10.980
F10.981	F10.982	F10.988	F10.99	F11.10	F11.11	F11.13
F11.14	F11.19	F11.20	F11.21	F11.23	F11.24	F11.29
F11.90	F11.93	F11.94	F11.120	F11.121	F11.122	F11.129
F11.150	F11.151	F11.159	F11.181	F11.182	F11.188	F11.220
F11.221	F11.222	F11.229	F11.250	F11.251	F11.259	F11.281
F11.282	F11.288	F11.920	F11.921	F11.922	F11.929	F11.950
F11.951	F11.959	F11.981	F11.982	F11.988	F12.10	F12.120
F12.121	F12.122	F12.129	F12.13	F12.150	F12.151	F12.159
F12.180	F12.188	F12.19	F12.20	F12.21	F12.220	F12.221
F12.222	F12.229	F12.250	F12.251	F12.259	F12.280	F12.288
F12.29	F12.90	F12.920	F12.921	F12.922	F12.929	F12.950
F12.951	F12.959	F12.980	F12.988	F12.99	F13.10	F13.120
F13.121	F13.129	F13.130	F13.131	F13.132	F13.139	F13.14
F13.150	F13.151	F13.159	F13.180	F13.181	F13.182	F13.188
F13.19	F13.20	F13.21	F13.220	F13.221	F13.229	F13.230
F13.231	F13.232	F13.239	F13.24	F13.250	F13.251	F13.259
F13.26	F13.27	F13.280	F13.281	F13.282	F13.288	F13.29
F13.90	F13.920	F13.921	F13.929	F13.930	F13.931	F13.950
F13.951	F13.959	F13.96	F13.97	F13.980	F13.981	F13.982
F13.988	F13.99	F14.10	F14.13	F14.14	F14.19	F14.20
F14.21	F14.23	F14.24	F14.29	F14.90	F14.93	F14.94
F14.99	F14.120	F14.121	F14.122	F14.129	F14.150	F14.151
F14.159	F14.180	F14.181	F14.182	F14.188	F14.220	F14.221
F14.222	F14.229	F14.250	F14.251	F14.259	F14.280	F14.281
F14.282	F14.288	F14.920	F14.921	F14.922	F14.929	F14.950
F14.951	F14.959	F14.980	F14.981	F14.982	F14.988	F15.10
F15.120	F15.121	F15.122	F15.129	F15.13	F15.150	F15.151
F15.159	F15.180	F15.181	F15.182	F15.188	F15.19	F15.20
F15.21	F15.220	F15.221	F15.222	F15.229	F15.23	F15.24
F15.250	F15.251	F15.259	F15.280	F15.281	F15.282	F15.288
F15.29	F15.90	F15.920	F15.921	F15.922	F15.929	F15.93
F15.94	F15.950	F15.951	F15.959	F15.980	F15.981	F15.982
F15.988	F15.99	F16.10	F16.14	F16.19	F16.20	F16.21
F16.24	F16.29	F16.90	F16.94	F16.99	F16.120	F16.121
F16.122	F16.129	F16.150	F16.151	F16.159	F16.180	F16.183
F16.188	F16.220	F16.221	F16.229	F16.250	F16.251	F16.259
F16.280	F16.283	F16.288	F16.920	F16.921	F16.929	F16.950
F16.951	F16.959	F16.980	F16.983	F16.988	F18.10	F18.11
F18.120	F18.121	F18.129	F18.14	F18.150	F18.151	F18.159
F18.17	F18.180	F18.188	F18.19	F18.20	F18.21	F18.220
F18.221	F18.229	F18.24	F18.250	F18.251	F18.259	F18.27
F18.280	F18.288	F18.29	F18.90	F18.920	F18.921	F18.929
F18.94	F18.950	F18.951	F18.959	F18.97	F18.99	F19.10
F19.120	F19.121	F19.122	F19.129	F19.130	F19.131	F19.132
F19.139	F19.14	F19.150	F19.151	F19.159	F19.16	F19.17
F19.180	F19.181	F19.182	F19.188	F19.220	F19.221	F19.222
F19.229	F19.230	F19.231	F19.232	F19.239	F19.24	F19.250
F19.251	F19.259	F19.26	F19.27	F19.280	F19.281	F19.282
F19.288	F19.29	F19.90	F19.920	F19.921	F19.922	F19.929
F19.930	F19.931	F19.932	F19.939	F19.94	F19.950	F19.951
F19.959	F19.96	F19.97	F19.980	F19.981	F19.988	F19.99
F45.42	G89.4	G89.21	G89.22	G89.28	G89.29	O99.320
O99.321	O99.322	O99.323	O99.324	Z51.81	Z76.0	Z79.891
Z79.899

Professional Statements and Societal Positions

Centers for Disease Control and Prevention (CDC) 2016

When prescribing opioids for chronic pain, clinicians should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.

American Society of Addiction Medicine (ASAM) 2017

Appropriate Use of Drug Testing in Clinical Addiction Medicine was published by ASAM in 2017.

"As a general principle, drug testing should be scheduled more frequently at the beginning of treatment. The Expert Panel recommends that an individual in early recovery be tested at least weekly. As the individual becomes more stable in recovery, the frequency of drug testing should be decreased, but performed at least on a monthly basis. Individual consideration may be given for less frequent testing if an individual is in stable recovery. If the individual returns to substance use after a period of abstinence, the provider should resume the early recovery testing schedule, possibly in conjunction with an adapted or intensified treatment plan."

ND Committee Review

Internal Medical Policy Committee 9-21-2020 - Coding update:
- Added Covered Diagnosis codes for Procedure Code 80305, 80306, 80307, 80375, 80376, 80377, G0480, G0481, G0482, G0483 and G0659 (48 services per benefit year): F10.130; F10.131; F10.132; F10.139; F10.930; F10.931; F10.932; F10.939; F11.13; F12.13; F13.130; F13.131; F13.132; F13.139; F14.13; F14.93; F15.13; F19.130; F19.131; F19.132; and F13.139
- Added for Non-Covered Diagnosis Codes for Procedure Codes 80320, 80321, 80322, 80323, 80324, 80325, 80326, 80327, 80328, 80332, 80333, 80334, 80335, 80336, 80337, 80338, 80345, 80346, 80347, 80348, 80349, 80350, 80351, 80352, 80353, 80354, 80355, 80356, 80357, 80358, 80359, 80360, 80361, 80362, 80363, 80364, 80365, 80366, 80367, 80368, 80369, 80370, 80371, 80372, 80373, 80374, 83992:F10.130; F10.131; F10.132; F10.139; F10.930; F10.931; F10.932; F10.939; F11.13; F12.13; F13.130; F13.131; F13.132; F13.139; F14.13; F14.93; F15.13; F19.130; F19.131; F19.132 and F19.139.
Internal Medical Policy Committee 11-19-20 - no changes made-annual review.

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