In-Office Urine Drug Testing: Avoid OIG Violations

Length: 60 Minutes Expert: Dreama Sloan-Kelly, MD, CCS, CPC CEU: 1.0

In-office urine drug testing claims continue to be on the Office of Inspector General’s (OIG) audit hit list. Meaning that these presumptive UDT claims have a high occurrence of errors and are being closely scrutinized by the OIG for violations.

A solo practitioner AND his practice manager from GA found out the hard way in March 2023. Based on an OIG audit, they agreed to pay $5 million to settle allegations that they violated the False Claims Act related to their in-office urine drug testing claims.

Even innocent errors when billing your UDT claims can result in audits and massive violation penalties (as demonstrated above), but it doesn’t have to be this way for you…

You can more accurately bill your in-office urine drug testing claims without it making your head hurt. Healthcare consultant and educator Dreama Sloan-Kelly, MD, CCS, CPC, will walk you through the complexities of more accurate UDT billing during her 60-minute online training. This practical step-by-step training will help you bill these complex claims to avoid OIG violations.

Here are just a few of the practical, plain-English billing tactics for in-office urine drug testing you’ll receive by attending Dreama’s online training session:

  • Master terminology (qualitative vs. quantitative; presumptive vs. definitive)
  • Pin down differences between Point of Service (POS) and Point of Contact (POC)
  • Improve drug unit and class coding with G0480, G0481, G0482, G0483
  • Uncover patient-specific elements that justify medical necessity for your testing
  • Correctly code “presumptive tests” by optical (visual) observation vs. those by instruments
  • Avoid claim denials for lack of medical necessity based on the different types of urine drug testing
  • Code Point of Service correctly: ICup AD, IScreen OFD, MultiDrug Screen Tests, etc.
  • Pinpoint when to report code 80305 and whether it applies even if you’re testing multiple drug classes
  • Make sure all testing elements are included: cups, collection charge, interpretation
  • Identify which CPT code(s) or code ranges to use with each different type of testing method
  • And much, much more.

IMPORTANT: Although federal guidelines state that all patients on long-term opioid therapy should undergo UDT at least annually, it also states that more regular testing should be at the discretion of the treating provider. Even so, the more often you provide in-office urine drug testing to your patients, the more likely you’ll get audited. This training will help you know “where to draw the lines” so your patients get the care they need, and your practice gets paid more of what you deserve.

Attending this online training means you won’t need a clinical chemistry or laboratory science degree to master the nuances of accurate in-office urine drug testing billing. You’ll get an easy-to-understand breakdown with actionable advice that will help you bill your UDT claims right the first time. Don’t wait. Sign up today.

Meet Your Expert

Dreama Sloan-Kelly
MD, CCS, CPCCEO of Kelly, Sloan and Associates, LLC

Dreama has over 14 years of experience in the medical field. A graduate of Wellesley College and Tufts University School of Medicine she has a varied background including clinical, billing, and coding. As CEO of Dr. Sloan-Kelly Consulting, Dreama speaks at various seminars, imparting her knowledge in an upbeat, matter of fact, manner.

Her goal is to provide attendees with only pertinent information to minimize the nonsense, and make sure everyone has fun at the same time. Dreama works with practices one on one, through coding consulting. She offers in-services seminars that can be held on or off-site. Dreama has learned in most seminars you spend a whole day only getting 20% of what you need, and 80% you leave – she has made it her goal to carve out the 20% that you need and giving you the take home message that will help you and your practice.