(Policy 19-001, effective 10/01/19)

Anthem Blue Cross and Blue Shield allows reimbursement for all definitive drug classes and presumptive drug testing on the same day. Effective October 1, 2019, definitive drug testing may be done to confirm the results of a negative presumptive test or to identify substances when there is no presumptive test available. Provider’s documentation and member’s medical records should reflect that the test was properly ordered and support that the order was based on the result of the presumptive test.


In the event a reference lab (POS = 81) performs both presumptive and definitive tests on the same date of service, records should reflect that the ordering/treating provider issued a subsequent order for definitive testing based on the results of the presumptive tests.


For additional information, refer to the Drug Screen Testing reimbursement policy at https://mediproviders.anthem.com/wi.


Featured In:
August 2019 Anthem Provider News - Wisconsin