Medicare guidelines for urine drug screening 2021. , optical observation, Urine Drug Screen Platform Move.

Medicare guidelines for urine drug screening 2021 Clinical Pathology Laboratories, Inc. Topic. Urine drug testing services include clinical studies and testing of urine obtained from the Medicare Drug Screen Testing. , Litholink Urine Test) 3. One presumptive drug testing code may be billed once per patient per day as indicated by the code description and should only be billed at one unit regardless of the provider. It seems that several MACs (Medicare Administrative Contractors) have teamed up to introduce changes to several high volume urine drug tests (UDT) that could greatly affect your practice. For more information, contact Provider Services at 1-800-682-9091. We publish a new announcement on the first calendar day of every month. National Urine Drug Test Policy Changes . Ening CPT code. Definitive urine drug testing: Used when it is necessary to identify specific illicit substances or metabolites present in the urine sample. Presumptive drug tests are normally reported by the treating provider using codes 80305, 80306, 80307. CMS emphasized that providers that perform validity testing on urine specimens cannot for SUD treatment programs), telehealth for controlled medications (e. In This Issue – February 2021 →. Recommendation #10 from the CDC Guideline for Prescribing Opioids for Chronic Pain states, “When prescribing opioids for chronic pain, clinicians should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs. Use this page to view details for the Local Coverage Article for Billing and Coding: Urine Drug Testing. PathWest’s specialist clinical pharmacology and toxicology laboratory team works with a range of government, industry bodies and private organisations across the state to support drug testing programs and to assist employers to meet their responsibilities under workplace health and safety legislation and guidelines. WASPLab® Automation for Microbiology. Per CPT guidelines each presumptive drug testing code represents all drug and Drug Supplement 1: eMethods eTable 1: U. Risk Group . Furthermore, the policy will • Optimize the care of members being treated with chronic opioids Among 318,549 Medicare beneficiaries with poor-prognosis cancers who died between 2007 and 2019, Black and Hispanic patients were substantially less likely to receive any opioids or long-acting opioids and received lower doses than White patients, while Black compared with White patients were also more likely to undergo urine drug screening. It is not intended to replace the published guidelines The information in this article contains billing, coding, or other guidelines that complement the Local Coverage Determination (LCD) for Urine Drug Testing L35724. Under Article Text added the sentence "The information in this article contains billing, coding, or other guidelines that complement the Local Coverage Determination (LCD) for Lab: Controlled Substance Monitoring and Drugs of Abuse Testing L36668" for the first paragraph and added the last paragraph. Drug testing/screening that states “custom profiling” and/or “conduct additional testing as needed. Accordingly, qualitative drug screen The term “patient” refers to a Medicare beneficiary. The methodology is considered when coding presumptive procedures. Fallon Health’s Clinical Coverage Documentation supplied for the CERT review is missing clinical documentation supporting medical necessity of the drug testing/screening billed such as documentation of suspected illicit drug use or non-compliance and/or documentation outlining the physicians' observations and rationale as to why a drug test/screening is needed. 1, 2021, Ohio Department of Medicaid (ODM) will adopt the HCPCS codes maintained by the Centers for Medicare and Medicaid Services (CMS) for the reporting of definitive urine drug tests and will no longer recognize the definitive drug test CPT codes established by the American Medical Coding Guidelines. Continuous urine drug testing (e. Return to top. The testing Medicare has LCDs for: • Use this page to view details for the Local Coverage Determination for Urine Drug Testing. The Jurisdiction E - Medicare Part A. Urine drug screens have been the most common UDT results influence treatment and level-of-care decisions for individuals with SUDs. The testing Medicare has LCDs for: • Date Issued: 9/30/2014. Accessed February 2, 2023. Drugs of Abuse Definitive Testing: CP. Drugs of Abuse: A DEA Resource Guide, 2020 Edition. CCA reimburses contracted providers for medically necessary urine drug testing (UDT) to detect drugs/drug metabolites as part of medical treatment for alcohol or substance abuse, or the abuse of prescription medications including medical pain management. Please refer to this policy for in-depth information on medical necessity for drug testing, documentation requirements, and CareSource monitoring and review of drug testing claims. To be eligible for the reimbursement, providers must meet all requirements specified within the policy. 50 Urine drug testing is a key diagnostic and therapeutic tool that is useful for patient care and monitoring of adherence to a controlled substance treatment Urine Drug Testing - a test used to detect the presence of a drug in a urine sample. Each presumptive drug testing code represents all drug and drug class tests performed by the respective methodology (i. California, Hawaii, Nevada, American Samoa, Guam, Northern Mariana Islands A monthly notice of recently approved and/or revised UnitedHealthcare Medicare Advantage Medical Policies is provided below for your review. However, a few states Urine Drug Screening Page 1 of 9 Clinical Coverage Criteria Effective 06/01/2019, Rev. Claims for G0481 may be appealed with clinical documentation. Formatting, punctuation and typographical CMS reminded organizations to pay attention to billing and coding for specimen validity testing done in conjunction with drug testing. Beginning 01/01/2020 our clinical and coding teams will use WellCare’s Drug Testing CPP (CPP-116) to ensure the extent and nature of the services rendered for a patient’s condition is justified, and WellCare will verify that submitted Per the Centers for Medicare and Medicaid Services (CMS)guidelines, 650: Guidelines for Urine Drug Screen Services,” document is available on . The appearance of a health service (e. Identify drugs when a definitive concentration of a drug is needed to guide management (e. Effective Jan. Summary . Date Published: 11/30/2024 < Return to Search. Medicare basics; Health & drug plans; Drug coverage (Part D) Providers & services; What Medicare covers; Site map; Overview of Controlled Substance Drugs of Abuse Testing Services There are two main types of tests used to detect controlled substances and drugs of abuse: Presumptive tests: CPT codes 80305–80306 are tests Medically Necessary: Presumptive urine drug testing (UDT) to verify compliance with treatment, identify undisclosed drug use or abuse, or evaluate aberrant* behavior, is considered medically necessary, beginning at the start of treatment, as part of a monitoring program tailored to the unique needs of individuals who are:. Medical Procedure Class: Controlled Substance Monitoring and Drugs of Abuse Testing Initial Implementation Date: January 1, 2015 Last Review Date: August 3, 2020 Effective Date: April 13 , 2021 Next Review/Revision Date: April 2024 * This document is not a contract, and these guidelines do not reflect or represent every conceived Standridge JB, Adams SM. : Medicine Last Reviewed: 08/10/2024 Last Revised: 08/10/2024 Approved: 08/08/2024 Effective: 09/01/2024 Policy applies to: Medicare Advantage . Medically Necessary: Presumptive urine drug testing (UDT) to verify compliance with treatment, identify undisclosed drug use or abuse, or evaluate aberrant* behavior is considered medically necessary, beginning at the start of treatment, as part of a monitoring program tailored to the unique needs of individuals who are:. Low Risk . One definitive drug testing code may be billed once per patient per day as indicated by the code description and should only be billed at one unit Presumptive drug testing, also known as drug screening, is used when necessary to determine the presence or absence of drugs or a Drug Class. gov/ency . state of all patients (n=3,395) eTable 2: Clinician rates of completed UDS per patient year, by month in care eTable 3: Urine drug screen results during baseline (first urine drug screen within 30 days of initiating treatment) and follow-up (closest urine drug screen to 180 days after initiating treatment, between 150 and 210 days For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. Drug testing/screening that includes drug(s) without potential for abuse. Visit the CMS Medicare Coverage Database (MCD) to access this LCD. Urine drug screening: a valuable office procedure. One definitive drug testing code may be billed once per patient per day as indicated by the code description and should only be billed at one unit Measurements: Percentage of patients tested for hepatis B, hepatis C, HIV and liver functioning; percentage of patients with urine drug screens and number of urine drug screens; continuous use of buprenorphine-naloxone for at least 180 days; co-use of benzodiazepines; number of outpatient visits with and without an OUD diagnosis. Testing can detect illegal or prohibited drug use, prescription medications, over-the-counter medicines, and legal substances such as alcohol and tobacco. What are the documentation requirements for definitive Presumptive/Qualitative Drug Testing (hereafter called "presumptive" UDT) - Covered when medically necessary to immediately determine the presence or absence of drugs or drug Guidelines for Urine Drug Tests – Z34. Refer to NCCI and OPPS requirements prior to billing Effective date: 09/01/2020 Revision date: 08/22/2024 Policy last review date: 08/22/2024 Purpose: This policy provides guidelines for the reimbursement of urine drug testing. Physician Administered Drugs This Medicare Advantage policy establishes Humana’s billing requirements regarding the Medicare Part B benefit for acupuncture for Clinician Checklist for Urine Drug Testing Last Updated 9/17/2024 1 JE CONTROLLED SUBSTANCE MONITORING AND DRUGS OF ABUSE TESTING This checklist isointended t provide healthcare providers with a reference for use when responding to documentation requests for this service. Drug testing using urine has been evaluated rigorously and is the most common biological substance used in the addiction treatment setting. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts. One definitive drug testing code may be billed once per patient per day as indicated by the code description and should only be billed at one unit 1 . . And you can see in the slide that the two numbers, DL36668 for JE and DL36707 for JF. 81for provider requirements and limitations Product: ☒Commercial ☐FEP ☐Medicare Advantage ☐Platinum Blue Description This policy addresses presumptive and definitive urine drug testing (UDT) and defines daily limits. Several alcohol and substance abuse CPT codes are commonly used in billing for substance abuse services. There is a documented history or suspicion of drug use by the Member including (but not limited to) illicit and also be referred to as drug screening. Title: Drug Testing Policy, Professional - Reimbursement Policy - UnitedHealthcare Commercial Plans and Individual Exchange Subject: This policy defines the daily and annual limits for presumptive drug testing codes (codes 80305, 80306, 80307, and H0003) and definitive drug testing codes (G0480, G0481, G0482, G0483, G0659, 0006U, 0007U, 0011U, and 0020U) and The Plan considers urine drug testing as not medically necessary for all other indications. Presumptive and definitive UDT not to exceed 2 times each in a rolling 365 days for prescribed medications, non- prescribed medications that may pose a safety risk if taken with prescribed medications, and illicit substances based on patient history, clinical presentation, and/or Under Coding Guidelines, removed statement: If a presumptive screen and definitive drug test are billed the same date of service after July 1, 2023 and medical necessity for definitive testing is met as stated in L34645 then the subsequent service is subject to NCCI edits and an appropriate NCCI modifier such as XE or XU should be added to the PI_MCR Policy #33 Outpatient Definitive Drug Testing – Medicaid and Medicare Approval Date: 8/11/2021 (Medical Clinical Policy Committee) Revision Date(s): 12/2/2021 A. In the setting of COVID-19, many states temporarily waived controlled medication prescribing barriers. Formatting, punctuation and typographical absence or presence of drugs or metabolites in a sample. Presumptive and definitive UDT not to exceed 2 times each in a rolling 365 days for prescribed medications, non- prescribed medications that may pose a safety risk if taken with prescribed medications, and illicit substances based on patient history, clinical presentation, and/or For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. Specimen validity testing: Used Effective Date: January 1, 2021 . 15, 2021 As published in Indiana Health Coverage Programs (IHCP) Bulletin BT201846, the IHCP covers presumptive urine drug testing (UDT) and definitive UDT when medically necessary. (CPL) recently underwent a post-payment Medical Review relating to Medicare beneficiaries who had a claim including procedure code G0480 - Drug test An overview of the minimum requirements to complete a urine drug screen (UDS) prior authorization (PA) request for Medicare, Medicaid, and BadgerCare Plus members. iSCREENâ„¢ Urine Test Dx Drug Screen Dip Card (Oxycodone (OXY)) • 80305QW May 25, 2023, Instant Technologies Inc. , discontinuation of THC use according to a treatment plan); CPT 2021 Professional Edition, 26 November 2020, ISBN: 1640160493. professional should always decide to perform urine drug screen testing in accordance with established clinical guidelines and practices. MP. For a list of Presumptive Group 1 codes and Definitive Group 2 codes, please refer to our LCD L35006, “Controlled Substance Monitoring and Drugs of Abuse Testing”. There is increasing interest in the use of hair as a specimen source for drug testing. Last Updated Aug 24 screenings, barium enemas (screening), multi‑target stool DNA tests (through age 85), and blood‑based bio‑marker screening tests for colorectal cancer (through age 85)). Baseline . This policy applies to ASCs, physicians, laboratories, other qualified health care professionals, hospitals, and Drug testing, commonly used in health care, workplace, and criminal settings, has become widespread during the past decade. For medical necessity criteria and coding guidance for Medicare Advantage members living outside of Under Article Text added the sentence "The information in this article contains billing, coding, or other guidelines that complement the Local Coverage Determination (LCD) for Lab: Controlled Substance Monitoring and Drugs of Abuse Testing L36707" for the first paragraph and added the last paragraph. See more Claims for drug screening services are payable under Medicare Part B in the following places of service: office (11), urgent care (20), independent clinic (49), federally qualified health center • All documentation must be maintained in the patient’s medical record and made available to the Medicare contractor upon request. Starrels JL, Becker WC, Alford DP, Kapoor A, Williams AR, Turner BJ. Concierge care. Systematic review: treatment agreements and urine drug testing to reduce opioid misuse in patients with chronic pain. Documentation Requirements; Drugs, Biologicals and Injections; Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) This proposed LCD is on Urine Drug Testing. American Family Physician. Formatting, punctuation and typographical Test Quick Guide. The 2018 Medicare fee-for-service improper payment data showed that laboratory testing, including UDT, had an improper payment rate of almost 30 percent, and that the overpayment rate for definitive drug testing for 22 or more drug classes was 71. Community health integration services . The billing and coding information in this article is dependent on the coverage indications, limitations and/or medical necessity described in the related LCD L36029 Urine Have an intake process to assess required elements per the Controlled Substance Monitoring and Drugs of Abuse Testing, LCD. ” Coverage Guidelines Drug screening and drug testing must be focused on detecting known illicit drugs or controlled substances or specified drug(s) of concern based on the member’s medical history or current clinical presentation. g. To view the policy, visit Reimbursement Policies & Guidelines . 2010; 152(11):712-720. This policy applies to participating and non-participating professional and laboratory providers for the following procedure codes: 80305, 80306, 80307, 80320-80377, G0480, G0481, G0482, Coding Guidelines. Specimen validity testing: Used DEFINITIVE URINARY DRUG TESTING T This Fact Sheet is for informational purposes only and is not intended to guarantee payment for services, all services submitted to Medicare must meet Medical Necessity guidelines. Stemming from a June 2021 audit report from the OIG calling on CMS to take action to curb the high The information in this article contains billing, coding, or other guidelines that complement the Local Coverage Determination (LCD) for Urine Drug Testing L35724. 2010;81(5):635-640. All plans (MCPs/MCOPs) must follow this guidance effective July 1, 2019. Drug testing/screening that does not meet the above guideline for drug panel selection. In addition, HPHC does not cover: 1. Frequency of Testing . Medical Necessity of Quantitative or Definitive Drug Testing Generally, whether quantitative (or definitive) urine drug testing for a particular drug is medically necessary depends on (1) the patient’s qualitative (or presumptive) testing results for that drug and (2) A number of substances may be used for drug testing, including urine, blood, hair, saliva and nails. , test, drug, device, or procedure) in the Medical Policy Update Bulletin does not imply that ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 – UPDATED January 1, 2021 (October 1, 2020 - September 30, 2021) The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), two departments within the U. https://medlineplus. Mandated drug testing (e. Coding Guidelines: Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. We believe the latest draft LCD put forward by Noridian is a positive and This Medicare Advantage and commercial policy outlines Humana’s reimbursement guidelines for urine culture testing for bacteria. Updated January 16, 2021. Specimen validity or adulteration testing 2. It can be qualitative or quantitative and is typically measured in ng/ml. Ann Intern Med. For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. These include: The CPT code for alcohol screening, typically billed under CPT 99408 with a Medicare Requirements Medicare Part B (provider component) covers two levels of tobacco cessation counseling for symptomatic and asymptomatic patients: intermediate (great than 3 minutes but no more than 10 minutes) and intensive (greater than 10 minutes). iSCREENâ„¢ URINE TEST DRUG SCREENING CLICK CUP Under Article Text added the sentence "The information in this article contains billing, coding, or other guidelines that complement the Local Coverage Determination (LCD) for Lab: Controlled Substance Monitoring and Drugs of Abuse Testing L36707" for the first paragraph and added the last paragraph. Refer to NCCI and OPPS requirements prior to billing WellCare has updated its Claims Payment Policy (CPP) for drug testing. Health Care; Unique ID: HHS-0938-2016-F-3271. , optical observation, Urine Drug Screen Platform Move. ” Quantitative tests as a replacement for drug screening services or as a 7. , buprenorphine), drug screening requirements, credentialing of providers delivering telehealth, and other state-level regulations. Executive Summary: American Association of Clinical Chemistry Laboratory Medicine Practice Guideline—Using Clinical Laboratory Tests to Monitor Drug Use this page to view details for the Local Coverage Determination for Urine Drug Testing. → Changing a Service Location . The Part B deductible applies. iSCREENâ„¢ Urine Test Dx Drug Screen Dip Card (Morphine (MOP)) • 80305QW July 17, 2023, Instant Technologies Inc. This may also be referred to as confirmative drug testing. • Two cessation attempts are covered per 12-month period. Formatting, punctuation and typographical substance abuse treatment. Receiving treatment for chronic pain with Coverage Guidelines Drug screening and drug testing must be focused on detecting known illicit drugs or controlled substances or specified drug(s) of concern based on the member’s medical history or current clinical presentation. The Clinical Coverage Guidelines (CCG) are evidence-based documents detailing the medical necessity of given procedures or technologies. Codes. Use this page to view details for the Local Coverage Determination for Urine Drug Testing. Effective June 7, 2021, Horizon NJ Health’s Urine Drug Testing Reimbursement Policy will have updated parameters. Jannetto PJ, Bratanow NC, Clark WA, et al. Service information includes, as applicable: National Coverage Determinations (NCDs) HCPCS & CPT codes; Prolonged preventive services information; ICD-10-CM diagnosis codes; Telehealth eligibility; Coverage requirements; Frequency requirements; Patient cost sharing Use this page to view details for the Local Coverage Determination for Urine Drug Testing. Receiving treatment for chronic medical necessity requirements for urine drug testing claims. Although a For most pain management services, you pay 20% of the Medicare-approved amount for visits to your doctor or other health care provider to diagnose or treat your condition. In addition to the definitive drug testing codes in the HCPCS manual (G0480, G0481, G0482, G0483 and G0659) use 80320-80377, and 83992 to report definitive drug class procedures. INDIANA HEALTH COVERAGE PROGRAMS BT202183 SEPTEMBER 14, 2021 Page 1 of 2 IHCP updates PA and billing requirements for urine drug testing, effective Oct. Education, counseling and referral, including a brief written plan for obtaining a screening EKG, as appropriate, and other appropriate screenings and/or Medicare Part B preventive services Medicare coverage for many tests, items and services depends on where you live. There’s no minimum age for getting a Medicare‑covered screening colonoscopy. , court-ordered, residential monitoring, non-medically necessary testing) 4. Commode chairs. S. Screen for potential substance use disorders (SUDs) 8. The Clinical Advisory Group of the Ohio Department of Mental Health and Addiction Services has established broad guidelines for the appropriate clinical use of urine drug screening (UDS) for patients with substance use disorder. In outpatient pain management and substance use disorder treatment, hair drug testing and oral fluid drug testing are considered INVESTIGATIONAL. Results are expressed as negative or positive. New Billing System - XiFin | Anticipated Launch Date: October 1st, 2024 07/06/2021. 02/10/2022 Urine Drug Screening Clinical Coverage Criteria meet medical necessity criteria in Medicare guidance, Fallon Health Clinical Coverage Criteria are used for coverage determinations for NaviCare members. Consistent with the Centers for Medicare & Medicaid Services guidelines (for reporting point-of-care qualitative drug-screen testing in a physician’s office), Current Procedural Terminology (CPT®) codes 80100, 80101 and 80104 will not be eligible for reimbursement when the services are billed on POS 11). Medicare is reviewing a new urine drug testing policy Use this page to view details for the Local Coverage Determination for Urine Drug Testing. Fallon Health’s Clinical Coverage Under Article Text added the sentence "The information in this article contains billing, coding, or other guidelines that complement the Local Coverage Determination (LCD) for Lab: Controlled Substance Monitoring and Drugs of Abuse Testing L36707" for the first paragraph and added the last paragraph. For patients with 31 to 90 consecutive days of abstinence, definitive More than 3 presumptive UDTs in a rolling 30 days is not reasonable and necessary and is not covered by Medicare. FEBRUARY 1, 2024 • Raised morphine confirmatory cutoff to 4,000 ng/mL • Publish a separate FRN annually with drug testing panel, biomarker testing panel, and required nomenclature • Report Substituted (not Invalid) based on biomarker testing • Require MRO semiannual summary reports to SAMHSA • 0328U may be reported and are considered under the policy guidelines pertaining to definitive drug testing. Prolonged Service Codes Urine Drug Screening → Changing a Remittance Address . Stemming from a June 2021 audit report from the OIG calling on CMS to take action to curb the high utilization of urine drug testing, Palmetto GBA, CGS Administrators and WPS Coding Guidelines. How often does Medicare cover it? • Screening colonoscopy— Under Coding Guidelines, removed statement: If a presumptive screen and definitive drug test are billed the same date of service after July 1, 2023 and medical necessity for definitive testing is met as stated in L34645 then the subsequent service is subject to NCCI edits and an appropriate NCCI modifier such as XE or XU should be added to the also be referred to as drug screening. Urine drug screen testing may be deemed medically necessary in several situations, depending on the specific circumstances and a provider’s judgment. Executive Summary: American Association of Clinical Chemistry Laboratory Medicine Practice Guideline—Using Clinical Laboratory Tests to Monitor Drug MAJOR CHANGES - URINE MANDATORY GUIDELINES. See associated Coding Guidelines at end of : Clinical guidelines, definitions, standards, and scenarios for drug testing are outlined in detail within the CareSource Drug Testing Medical Policy, MM-0054. e. Each category of a drug class, including metabolite Urine drug testing should be ordered by a clinician during an office visit. UDT panels. • 80305QW July 17, 2023, Instant Technologies Inc. Education, counseling and referral, based on the results of numbers 1–7 in this list 9. The agency reviewed recent code changes and billing guidelines for these lab tests in Special Edition MLN Matters 18001 released on March 29. While there is no rule prohibiting a clinical laboratory from developing UDT panels, the treating clinician must be offered the choice of each specific drug for confirmatory testing. Please share this notice with other members of your practice and office staff. Urine drug testing detects evidence of recent drug use or misuse in a sample of urine. 7 percent. Prior to Initiation of COT. Published Date: 07/06/2023 05/14/2021. Federal Government’s Department of Health Mental and behavioral Per our Commercial and Medicaid Urine Drug and Alcohol Testing policy*, HCPCS codes G0481-G0483 are not covered when definitive drug testing is done prior to an initial screen or used to identify drug classes other than the one(s) in question. Colorectal cancer blood-based biomarker screening tests. The definition of “medically necessary” for Medicare purposes can be found in Section 1862(a)(1)(A) of Urine Drug Screening Page 1 of 9 Clinical Coverage Criteria Effective 06/01/2019, Rev. Final Urine Drug Testing LCD and Associated Billing and Coding: Urine Drug Testing - Effective October 08, 2023 that support the medical necessity of Urine Drug Testing and the Billing and Coding Article provides billing and coding guidance for the LCD. ; If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital. OHCA Guideline . Therefore, if a drug is self-administered by more than 50 percent of Medicare beneficiaries, the drug is excluded from coverage" and the MAC will make no payment for the drug. It also More than 1 physician-directed testing profile in one week is not reasonable and necessary and is not covered by Medicare. kcupuqr psdorf igfshw nnjd gekpcl ouxd xwwlh wtfit wulir tizfd