81000 help

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How do we get Medicare to pay a urinalysis for a presumed UTI? They are denying 81000 on claims. Is there a Gcode or HCPCS code I should use? I am in KY. My provider has a CLIA. Thanks for your help
 
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I didn't know you needed a QW for 81000. I know 81003 needs a QW. Have you been successful with MDCR using the QW with 81000 in the last few months? Thanks for your help.
 

cgaston

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The doctors let their CLIA certification lapse so we have been holding off billing urine dips until that gets straightened out. :eek:

QW came to mind since the last coder noted that the dips need a QW. I took over this mess when their coder quit. If I am lucky they will hire a new one in time for this problem to become their problem! (kidding...sort of :p )

However, I did a little research on this (since we will be billing them out eventually) and I am thinking we should be billing 81002 instead of 81000 since I don't see any mention of microscopic analysis in the note. 81002 is just visually comparing the dip stick to the color chart on the side of the container which seems more in line with what they note. Time to query the office on their urinalysis procedures.

Sorry I couldn't be more helpful.
 

048fanita

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81000

in my 10+ in urology we always dip it and run it through the clinitek. we use code 81003 with a QW. I usually use the dx as frequency, hesitancy, etc
 
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