Primary Care Coding Alert

Question: One of our payers is handling the following three urinalysis codes differently: 81002, 81003 and 81015. When should I use each code? Also, can you tell me when it is beneficial to challenge a denial of incident to on a urine dip?

Illinois Subscriber

Answer: The four CPT codes in the urinalysis series, 81000-81003, describe urinalysis, by dip stick or table reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrate, pH, protein, specific gravity, urobilinogen, any number of these constituents. Further description indicates that code 81000 is nonautomated, with microscopy; 81001 is automated, with microscopy; 81002 is nonautomated, without microscopy; and 81003 is automated, without microscopy. None of these codes should be used with code 81015 (urinalysis; microscopic only) because it would be considered unbundling according to the Correct Coding Initiative.

Dont spend too much time or effort challenging a denial of incident to on a urine dip. You probably wont receive a large reimbursement and may waste a lot of time and energy. If you are experiencing denials, consider a standardized letter that could be used each time. Design the letter so it would take only a few minutes to complete with the patients name and identification number. Nonetheless, you still will need to invest in the cost of the stationery and stamp for the $2-4 you might be reimbursed.