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Urology Coding Alert

Reader Questions:

Payer Preference Determines G0027 Vs. 89321

Published on Fri Oct 15, 2010

Question: Code HCPCS G0027 is listed as a providerperformed microscopic procedure to test for the presence of sperm post-vasectomy. Would CPT 89321 be the equivalent? Florida Subscriber Answer: Yes, codes G0027 (Semen analysis; presence and/or motility of sperm excluding huhner) and 89321 (Semen analysis; sperm presence and motility of sperm, if performed) are equivalent. You'll need to check with each payer to determine which code to report. For Medicare, use 89321. Keep in mind: Your practice is not allowed to perform many basic laboratory services without Clinical  Laboratory Improvement Amendments (CLIA)-waived status. So if your practice does not get the waiver, you could be missing out on possible pay for some simple screens, such as the semen analysis tests. If your practice has CLIA-waived status, you can  perform (and bill for) these tests and others. For your practice to perform CLIA-waived testing, Medicare requires that you: • Enroll in the [...]
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