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Urine Drug Testing in Pain Management and Substance Abuse Treatment Settings

Effective September 3, 2014, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider claims for urine drug testing performed in pain management and substance abuse treatment settings.

Based on our guidelines of the revised medical policy, Urine Drug Testing in Pain Management and Substance Abuse Treatment Setting , claims for additional urine drug testing performed during a course of treatment in a pain management or substance abuse treatment setting (following the initial urine drug test) will pend while information to determine medical necessity is requested and reviewed. Medical necessity review is not required for the initial urine drug test performed in a pain management or substance abuse treatment setting.

The guidelines of our revised medical policy, Urine Drug Testing in Pain Management and Substance Abuse Treatment Setting , are aligned with nationally recognized clinical criteria, current industry standards and American Society of Interventional Pain Physicians (ASIPP) guidelines.

This revised medical policy is available in our online Medical Policy Manual. To access this information, click the link above or:

  • Select Medical Policies and PreCert.
  • Select Medical Policy Manual.
  • Search for and select Urine Drug Testing in Pain Management and Substance Abuse Treatment Setting.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service on and after September 3, 2014.

Published on: June 3, 2014, 07:32 a.m. ET
Last updated on: November 24, 2020, 23:13 p.m. ET