From the Research
Providers typically use the ICD-10 code Z79.899 (Other long term (current) drug therapy) to have Medicare cover a urine drug screen (UDS) prior to starting a stimulant medication. This code indicates that the patient is on or will be starting a medication that requires monitoring. For stimulant medications specifically, you might also consider using codes such as F90.9 (Attention-deficit hyperactivity disorder, unspecified) or other relevant diagnostic codes that justify the need for the stimulant. When ordering the UDS, it's essential to document medical necessity clearly in the patient's chart, noting that the screening is being performed as part of responsible prescribing practices for controlled substances. Medicare generally covers medically necessary drug screenings when properly documented and coded, as seen in various studies 1, 2. The rationale behind pre-stimulant UDS testing is to establish baseline substance use status, identify potential drug interactions, and promote patient safety when prescribing controlled substances with abuse potential. This practice aligns with risk mitigation strategies recommended for prescribing controlled substances, and is supported by recent research on the effectiveness of combination therapies for ADHD treatment 1. Key points to consider when ordering a UDS prior to starting a stimulant include:
- Documenting medical necessity in the patient's chart
- Using relevant ICD-10 codes, such as Z79.899 or F90.9
- Ensuring proper coding and documentation for Medicare coverage
- Aligning with risk mitigation strategies for controlled substance prescribing
- Considering the potential benefits of combination therapies for ADHD treatment, as supported by recent studies 1.