Pathology/Lab Coding Alert

Question: Our lab performs urinalysis using a chem-strip method. What is the proper code?
Kentucky Subscriber

 Answer: Aside from urine cultures, CPT provides numerous codes for urinalysis. You have to select the code that most closely matches the procedure your lab performs from the following list:
- 81000 -quot; Urinalysis, by dipstick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non- automated, with microscopy
- 81001 -quot; - automated, with microscopy
- 81002 -quot; - non-automated, without microscopy
- 81003 -quot; - automated, without microscopy
- 81005 -quot; Urinalysis; qualitative or semiquantitative, except immunoassays
- 81007 -quot; - bacteriuria screen, except by culture or dipstick
- 81015 -quot; - microscopic only.

 Because you don't mention performing microscopy, you can eliminate 81000, 81001 and 81015.
 Determine automation: The -chem-strip- that you describe is the -dipstick- method. To select the proper code, you need to know if you-re performing an automated or non-automated procedure.
 If you place the strip in a -strip reader- that prints out a report, you should report 81003 or 81003-QW (CLIA waived test) depending on your status under the Clinical Laboratory Improvement Amendments (CLIA).
 If you visually compare analytes on your strip with the container graph, you-re performing the manual technique and should report 81002. You don't need modifier QW with this code, even if you are a CLIA-waived lab.
 Keep in mind: You should never fragment a urinalysis service and report it with multiple codes if a single code describes the service.
 For example: Your lab carries out a non-automated dipstick urinalysis with microscopic evaluation.
 Correct coding: Report one unit of 81000.
 Incorrect coding: Report both 81002 and 81015.