Coastal Spine & Pain Center (CSP&PC) urinalysis testing is a “one size fits all” procedure. This means they use a standard urinalysis machine, which is often inaccurate and can lead to false negative results. Additionally, it can be costly, and they do not offer information on how much drug is taken.
False-negative results
Using a urine drug test (UDS) to monitor pain management patients is a common practice. However, false negative drug urinalysis results can be caused by several reasons. Besides the obvious possibility of the patient tampering with the urine sample, the result can also be due to a clerical or laboratory error.
A quantitative urine opiate test can identify a particular drug with high specificity. However, false negative results are expected with agents that follow different metabolic pathways.
An immunoassay can be used to screen for a variety of drug metabolites. This is convenient because it can be performed in the physician’s office. If the doctor or pharmacist suspects the drug may be in the urine, they can consult a professional for advice.
A false negative urine test can be easily avoided by following simple measures. For instance, urine samples should be collected randomly. The pH of the model should be between 4.5 and 8. The concentration should be between 1.002 and 1.030.
Another critical point to consider is the type of immunoassay used. If the doctor is unsure of the assay’s accuracy, they should ask for a retest.
False negatives can occur when the sample is collected at a time when the concentration of the drug is low, for example, in the early morning.
A benzodiazepine urine test typically detects oxazepam, but the concentration can vary greatly. Other drugs that can cause a false positive include diphenhydramine and doxylamine.
A majority of patients will collect the urine unobserved. Nevertheless, a minority of patients will attempt to manipulate the test. For example, a patient might drink large amounts of water or try to influence the urine sample in other ways.
Cost
During the last few years, urine testing has become an extremely lucrative business for some pain management physicians. But some have been accused of running unnecessary tests. The results of these tests can reveal whether patients are adhering to their treatment plans. They can also show illicit substance use.
According to a recent report, one of the nation’s largest labs, Millennium Health, has been conducting widespread urine drug testing in Arizona. This includes dozens of pain management doctors. They have collected as much as 80 percent of their Medicare income from testing.
However, many providers have yet to learn what is being tested. And the test may not be medically helpful. Some physicians are even charging exorbitant rates.
Some physicians argue that they must perform many urine tests to keep patients from abusing pain pills. Some critics believe this is a profit-grubbing scheme.
A urinalysis test can range from $30 to $250. The price will depend on the test type and the testing location. The depth of the test is also a factor.
For example, a simple cup test can detect several classes of drugs on the spot. This typically costs less than sending a specimen to a central lab. A more extensive quantitative test can cost up to $2000.
Some labs have been sued for excessive testing. These lawsuits usually involve billings of $9,000 or less.
The actual cost of a urinalysis urine test can vary from state to state. The cost will depend on your insurance. If your insurer does not pay for the test, you might have to pay a co-pay.
In addition, some physicians have been accused of using questionable billing practices. These include a Houston anesthesiologist, Phillip C. Phan, who owns a pain clinic called Sunset Labs LLC. Three doctors sued him. He resigned in April 2015 because of the accusations.
Repetitiveness
Despite being one of the most prevalent drugs on the market, phencyclidine (PCP) is seldom detected in the urine of a pain patient. While a lot of money has been spent on drug testing, it is unlikely that the medical community has determined a definitive answer to the question, “Which is the best way to test for PCP in the urine of a pain patient?”
The FDA issued a study in 2013 suggesting that urine testing is not an excellent way to determine if a patient has PCP in their system. The American Academy of Pain Management also disagreed, arguing that urine testing in pain management is not a good use of taxpayer funds.
Although the Centers for Disease Control and Prevention (CDC) did not set a national standard for urine testing, the agency did say that the best way to determine if a patient is taking a substance is to use a screening assay. The CDC has recommended that physicians perform screening assays to measure the levels of opioids in the urine of patients receiving long-term opioid therapy.
The CDC also recommended that clinicians perform screening assays to determine whether their patients adhere to their pain medication treatment plans. The most important thing to remember is that a pain management patient does not have to know when they will be tested. Some state boards also frowned on trying patients regularly.
A few years ago, Millennium Health received $166 million in Medicare reimbursements and was a target of eight whistleblower lawsuits. The company was also the recipient of the first-ever lab fee reset by the federal government.
Coastal Spine & Pain Center’s urinalysis testing is “one-size-fits-all.”
According to a new report from Kaiser Health News, Coastal Spine & Pain Center, a Florida-based network of clinics, is accused of submitting claims for drug testing for patients who did not receive appropriate treatment. According to government documents and billing experts consulted by the magazine, several clinics have been charged for billing Medicare for testing that is not medically necessary.
The Centers for Medicare & Medicaid Services has not commented on the charges but has a policy of only paying for medically necessary services. Despite that, the practice was billed for tests it did not provide, including specialized tests that are more expensive. In addition to paying for urine screenings, Coastal Spine & Pain Center billed for a costly second test to confirm its findings, according to the report. The company said it tried to be “judicious” in ordering the tests, but the audit called for repayment of more than $7,000. According to Medicare payment data, the four doctors who billed for the testing were among the top 50 billers for Medicare in 2014. The three other Coastal Spine & Pain Center doctors billed for drug tests were among the top 50 in 2015.
According to Medicare’s data, Coastal Spine & Pain Center’s drug testing revenues dropped by 32 percent in the first quarter of 2016 after increasing by almost 100 percent in the fourth quarter of 2014. In addition to the urine testing, the doctors also billed for cup testing, a process in which cups of urine are transported by express mail to a lab in Brentwood, Tenn.
