2019-29: Changes to Urine Drug Testing Effective July 1, 2019

Date: 05/10/19

On May 1, 2019, the Louisiana Department of Health released HPA 19-10 (PDF) stating Medicaid will adopt the following changes to the coverage of urine drug testing:

• Presumptive drug testing is limited to 24 total tests per enrollee per calendar year. Providers are to consider the methodology used when selecting the appropriate procedure code for the presumptive testing.
• Definitive drug testing is limited to 18 total tests per enrollee per calendar year. CPT codes 80320-80377 for individual substance(s) or metabolites will no longer be covered. Providers should instead use HCPCS codes G0480 [Drug tests, definitive … per day, 1-7 drug class(es), including metabolite(s) if performed] or G0481 [Drug tests, definitive … per day, 8-14 drug class(es), including metabolite(s) if performed] or their successors.
• Testing more than 14 definitive drug classes per day is not reimbursable.

These changes are effective for dates of service on or after July 1, 2019.

Please note: No more than one presumptive and one definitive test will be reimbursed per day per enrollee, from the same or different provider.

Louisiana Healthcare Connections is updating its system to accommodate the alternative payment methodology.