When coding for toxicology, knowing when to use AMA and CMS codes is key as there can be great variance in reimbursement. In this post, you'll find more information on billing AMA versus CMS.
Compliance plays a significant role in toxicology testing. The two biggest items usually overlooked are how often high complexity testing is done for repeat patients, along with the collection of patient balances. Guidelines state testing on patients should be individual to the patient’s specific medical history; standing orders or custom panels that apply to all the physician’s patients is not individualized. The clinician’s documentation must be patient specific and accurately reflect the need for each test. We assist ensuring that confirmatory tests should be performed to confirm a positive qualitative result and the rationale for each confirmatory test should be supported by the ordering clinician’s documentation.