Urinalysis Coding

tviruet

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Good afternoon.

I am reviewing a denial that was brought to my attention because both, CPT 81001 & 81002, UA codes were billed:

I did a little of my own investigation to find out why both tests were performed and was informed that both tests are routinely ordered for OB patients.

They also stated that 81002 is done routinely for GYN patients; however, if they identify any abnormalities, they do the automated test w/ microscopy - CPT 81001.

Because they have a protocol in place, can they bill both codes? And, If both tests were performed because an abnormality was identified using 81002 (non-automated w/out microscopy), is it fair to use a modifier 59?

Thank you so much.
 
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