Wiki Routine UA with PSA screening

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linton@bresnan.net

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Per our urologist new prostate screening guidelines have emerged stating besides the PSA test, a routine UA should be ran as well. We are trying to be proactive regarding reimbursement, the concern is the UA, 81000, will be denied using the Z12.5, Encounter for screening for malignant neoplasm of prostate. I've check several LCD/NCD sites for code 81000, and am getting conflicting information, one site states no edits, another gives a list of Z codes that does not include Z12.5, nor Z12.79 Encounter for screening for malignant neoplasm of other genitourinary organs. The use of ABN form has not been discussed yet, but we will. Any assistance is appreciated.
 
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Hi Linton;)
Try CPT code 84153 for prostate lab test. Link with possible dx N28.89 or N42.9 or E29.1 per provider s documentation & patient s problems.
Well hope this helps you somewhat.:)
Lady T
 
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