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Format: On-Demand Webinar
Presenter: Kristen R. Taylor, CPC, CHC, CHIAP
Time: You can access the webinar anytime
Duration: 60 minutes
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With the nuances of urine drug screening and pain management, the risk is high for compliance! In this presentation, we will discuss how risk is quantified in pain management along with numerous Risk Stratification Assessment tools to validate your compliance. We will also discuss the difference between “presumptive” and “confirmatory” drug screen testing.  After this presentation, you will be able to judge your risk level based on regulatory guidance along with a review of enforcement actions paid by several pain management providers. At the end of this session, you will be able to distinguish between all types of drug screenings including Presumptive, Confirmatory, Reflex Testing, and Frequency measures. Please join us for an informative and very interactive hour!

Learning Objectives:

  • Understand the risk in pain management and how it is quantified
  • Differentiate between presumptive and confirmatory urine drug screens
  • Review regulatory guidance that drives frequency and the appropriateness of urine drug screens
  • Define “Pain Management” and discuss Risk Stratification Assessment tools to assist with compliance and regulatory measures
  • Define a Patient Risk Level and how this determines how and when a patient qualifies for a UDS
  • Differentiate between several types of UDS including Presumptive, Confirmatory, and Reflex Testing, and review the frequency of the stated types of testing.
  • Review current DOJ/ OIG probes and how the providers were affected

Areas Covered in the Session

  • Risk of Pain Management
  • Key Points
    • Pain medications
    • Physical Therapy
    • Psychological Therapy
    • Mind/body techniques
    • Community support groups
  • 5 Key Components of the Pain Assessment
    • Pain
    • Intensity
    • Location
    • Duration
    • Aggravating or alleviating factors
  • 3 common types of tools to quantify pain
    • Verbal rating scales
    • Numeric rating scales
    • Visual analog scales
  • 4 areas Risk Assessment should include
    • Recognizing the risk
    • Committing to precautions to reduce the risk
    • Clearly state the roles and responsibilities of the patient and provider
    • Explain what is expected from the patient
    • Urine Drug Screens
    • Presumptive Drug Screening
    • Confirmatory or “Definitive” Drug Screening
    • Billing and Coding: Urine Drug Testing
      • Group I CPT® Codes for Presumptive Testing
      • Per CMS LCD (L36037)
      • Per CMS Article A56761
    • Coding and Billing Guidelines
      • Medicare
      • Other Payers
    • Controlled Substance Monitoring & Drugs of Abuse Testing
    • Required Documentation
    • Reasons to Use Clinical Drug Testing
    • Risk
    • Opioid Risk Tool
    • DAST-10
    • Summary & Recommendations

Suggested Attendees

  • Beginner, Advanced, Expert Coders
  • Laboratory Personnel and Nurses
  • Office Managers
  • Directors, Executive Directors, CEOs and CFOs
  • Billers and Reimbursement Professionals
  • Consultants and Owners
  • Physicians
  • Billers
  • Coding Supervisors
  • HIM Director
  • HIM staff
  • Anesthesia Providers
  • Auditors
  • Compliance personnel

About the Presenter

Kristen joined Pinnacle Enterprise Risk Consulting Services as a managing director in 2016, bringing 30 years of experience in coding, revenue cycle processes and compliance for physician and hospital reimbursement models. Kristen conducts operational assessments, attorney-client privileged investigations for billing and reimbursement anomalies applicable to her expertise, coding reviews and provider/ coder education.

Prior to consulting, Kristen managed the ancillary and surgical (OR) coding and billing staff for the departments of pathology and laboratory medicine, anesthesia, certified registered nurse anesthetist, diagnostic and interventional radiology services rendered within the facility and procedures performed in the OR suite for all surgical departments. Kristen is a Certified Professional Coder with the American Academy of Professional Coders (AAPC) and Certified in Healthcare Compliance with the Health Care Compliance Association (HCCA). She has written articles and spoken nationally for HCCA,  AAPC and AHIA. Her specialty experience includes radiation oncology, diagnostic and interventional radiology, anatomic pathology, primary care, anesthesia, and pain management.

Course Content

You can access all the webinar materials after successful payment

  • Webinar Link + Handouts PDF
  • Course Link
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