Pain Management

Medication Monitoring with Urine Drug Testing in Pain Management

Supporting comprehensive pain management

Urine drug testing (UDT) is a useful tool in pain management that provides valuable objective information to assist in diagnostic and therapeutic decision making. Results of a UDT provide confirmation of the agreed-upon treatment plan (adherence/compliance). They can diagnose relapse or drug misuse as early as possible, and they also can be used to advocate for the patient with third-party interests.

The purpose of UDT should be explained to the patient at the initial evaluation. UDT can also enhance the relationship between healthcare professionals and patients by providing documentation of adherence to mutually agreed-upon treatment plans.

The question of whom to test is made easier by having a uniform practice policy either in a pain or primary practice that would help reduce individual stigma. Any risk of patient profiling based on racial, cultural, or other physical appearances is eliminated. Careful explanation of the purpose of testing normally allays patient concerns.

Medicare Coverage Policy

Testing should be performed for:

Monitoring is covered but must be based upon patient history and clinical assessment including:

Random Testing Frequency for Chronic Opioid Therapy

Risk Stratification Frequency
Low Risk 1-2 times every 12 months
Moderate Risk 1-2 times every 6 months
High Risk 1-2 times every 3 months

Frequency limits may be exceeded based upon:

Confirmation testing to confirm a positive presumptive (screen) result is allowed:

When the test result is inconsistent with

Non-Covered Services

Custom Panel Compliance Requirements