Policy Updates Reimbursement PoliciesCommercialAugust 31, 2021

Reimbursement policy update: Drug Screen Testing (Professional)

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Material adverse change (MAC) notification

 

Beginning with dates of service on or after December 1, 2021, Empire BlueCross BlueShield (“Empire”) will update the policy to indicate that separate reimbursement is not allowed for specimen validity testing when utilized for drug screening because it is included in the CPT and HCPCS code descriptions for presumptive and definitive drug testing. Modifiers will not override this edit; therefore, we have included this information in our Distinct Procedural Services (Modifiers 59, XE, XP, XS, XU) reimbursement policy.

 

For more information about this policy, visit the Reimbursement Policy page at empireblue.com/provider.


1309-0921-PN-NY