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Wiki Urinalysis and E/M on same day

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ChrissyMiodrag

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When a urinalysis is done on the same day as an E/M service, can you bill and be paid for the urinalysis, if so what modifier do you use?

Thank you
Chrissy
 
I work for a large urology practice so we bill urinalysis all the time. An E&M and a urinalysis can be paid on the same day. We don't use modifiers when we bill both of these, with one exception. There is one insurance in particular where we have found that we need to use modifier -25 on the E&M in order to be paid for the u/a. Also, certain carriers will not pay on a u/a when we're billing level 4 of level 5 established E&M codes, or on consult codes. They end up bundling the u/a into the office visit. Hope this helps.

Zaida V. Aquino, CPC
 
When I worked in Urology we did UA's on everyone who walked in the door and were able to bill for them (most of them ) with the modifier -25 also.
Hope this helps.
Robyn
 
But labs are not considered a procedure, which is what a -25 applies to when an E/M was done on the same day as a procedure.
 
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