Pathology/Lab Coding Alert

Question: Which code should our physician-office lab use to report urine tests that we perform to help screen for a variety of conditions such as diabetes, urinary tract infections and jaundice? Kansas Subscriber Answer: Many different urine tests are available to help diagnose the conditions you mentioned, so there is not one code that answers your question. To perform tests, your lab must be certified under the federal Clinical Laboratory Improvement Act (CLIA). Your certification level limits which tests you can perform. Most likely, a physician-office lab operates under CLIA "waived" status, meaning you may not perform any tests of a complexity that require a higher certification level. Most of the urinalysis codes are based on the test method and analyte, so you'll have to know this information to select the code. Although commercial test-kit manufacturers may recommend a CPT code, they are not always correct, and you should double-check against the code definitions. You can find a comprehensive list of CLIA-waived tests, including information on tests from specific manufacturers, at www.cms.hhs.gov/clia/waivetbl.pdf. Some examples of tests you may perform in your physician-office lab follow: 81002 Urinalysis, by dipstick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; nonautomated, without microscopy 81003 automated, without microscopy This code describes the Bayer Clinitek 50 Urine Chemistry Analyzer, the Chemstrip Mini UA from Boehringer Mannheim, and the Roche Diagnostics/ Boehringer Mannheim Chemstrip 101, for example. 81007 Urinalysis; bacteriuria screen, except by culture or dipstick This code describes the Diatech Diagnostics Uri screen that is approved for over-the-counter use and detects catalase that is associated with urinary tract infections.