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Urinalysis - MEDICAID CODING GUIDELINE, Schemes and Mind Maps of Calculus

Stanford UniversityCalculus

CPT CODES: 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific.

Typology: Schemes and Mind Maps

2022/2023

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MEDICAID CODING GUIDELINE
Effective:
URINALAYSIS
CPT CODES: 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose,
hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific
gravity, urobilinogen, any number of these constituents;
non-automated, with microscopy
81001 automated, with microscopy
81002 non-automated, without microscopy
81003 automated, without microscopy
81005 Urinalysis, qualitative or semi-quantitative, except
immunoassays
81007 Urinalysis, bacteriuria screen, by non-culture, commercial kit
81015 Urinalysis, microscopic only
81025 Urine pregnancy test, by visualcolor comparison methods
81050 Volume measurement for timed collection, each
COVERED DIAGNOSIS:
016.00-016.96 Tuberculosis of genitourinary system
038.0-038.9 Septicemia
054.10-054.19 Genital herpes
070.0-070.59 Viral hepatitis
072.0 Mumps orchitis
078.11 Condyloma acuminatum
078.88 Other specified diseases due to chlamydia infection
079.81-079.89 Other specified viral and chlamydial infections
079.98 Unspecified chlamydial infection
087.0-087.1 Relapsing fever
095.4 Syphilis of kidney
098.0 Gonococcal infection, acute, lower genitourinary tract
098.10-098.19 Gonococcal infection, acute, upper genitourinary tract
098.2 Gonococcal infection, chronic, of lower genitourinary tract
098.30-098.39 Gonococcal infection, chronic, of upper genitourinary tract
098.89 Other Gonococal infection of other specified sites
099.3 Reiter’s disease
099.40-099.49 Nongonococcal urethritis
099.53-099.54 Other venereal diseases due to Chlamydia trachomatis
100.0 Leptospiral icterohemorrhagica
102.0-102.9 Yaws
112.1 Candidasis of vulva and vagina
125.0-125.1 Filarial infection and dracontiasis
131.00-131.03 Urogenital trichomoniasis
185 Malignant neoplasm of prostate
186.0-186.9 Malignant neoplasm of testis
188.0-188.9 Malignant neoplasm of bladder
189.0-189.9 Malignant neoplasm of kidney and other and unspecified urinary organs
198.0-198.1 Secondary malignant neoplasm of kidney and other urinary organs
222.2 Benign neoplasm of prostate
223.0-223.3 Benign neoplasm of kidney and other urinary organs
223.81-223.89 Benign neoplasm of urethra and other urinary organs
223.4 Carcinoma in situ of prostate
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MEDICAID CODING GUIDELINE

Effective:

URINALAYSIS

CPT CODES: 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose,

hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy 81001 automated, with microscopy 81002 non-automated, without microscopy 81003 automated, without microscopy 81005 Urinalysis, qualitative or semi-quantitative, except immunoassays 81007 Urinalysis, bacteriuria screen, by non-culture, commercial kit 81015 Urinalysis, microscopic only 81025 Urine pregnancy test, by visualcolor comparison methods 81050 Volume measurement for timed collection, each

COVERED DIAGNOSIS:

016.00-016.96 Tuberculosis of genitourinary system 038.0-038.9 Septicemia 054.10-054.19 Genital herpes 070.0-070.59 Viral hepatitis 072.0 Mumps orchitis 078.11 Condyloma acuminatum 078.88 Other specified diseases due to chlamydia infection 079.81-079.89 Other specified viral and chlamydial infections 079.98 Unspecified chlamydial infection 087.0-087.1 Relapsing fever 095.4 Syphilis of kidney 098.0 Gonococcal infection, acute, lower genitourinary tract 098.10-098.19 Gonococcal infection, acute, upper genitourinary tract 098.2 Gonococcal infection, chronic, of lower genitourinary tract 098.30-098.39 Gonococcal infection, chronic, of upper genitourinary tract 098.89 Other Gonococal infection of other specified sites 099.3 Reiterís disease 099.40-099.49 Nongonococcal urethritis 099.53-099.54 Other venereal diseases due to Chlamydia trachomatis 100.0 Leptospiral icterohemorrhagica 102.0-102.9 Yaws 112.1 Candidasis of vulva and vagina 125.0-125.1 Filarial infection and dracontiasis 131.00-131.03 Urogenital trichomoniasis 185 Malignant neoplasm of prostate 186.0-186.9 Malignant neoplasm of testis 188.0-188.9 Malignant neoplasm of bladder 189.0-189.9 Malignant neoplasm of kidney and other and unspecified urinary organs 198.0-198.1 Secondary malignant neoplasm of kidney and other urinary organs 222.2 Benign neoplasm of prostate 223.0-223.3 Benign neoplasm of kidney and other urinary organs 223.81-223.89 Benign neoplasm of urethra and other urinary organs 223.4 Carcinoma in situ of prostate

223.7 Carcinoma in situ of bladder 233.9 Carcinoma in situ and other unspecified urinary organs 236.5 Neoplasm of uncertain behavior of prostate 236.7 Neoplasm of uncertain behavior of bladder 236.90-236.99 Neoplasm of uncertain behavior of other and unspecified urinary organs 250.00-250.93 Diabetes mellitus 253.5-253.6 Diabetes insipidus and other disorders of neurohypophysis 271.4 Renal glycosuria 272.2-272.4 Mixed and other unspecified hyperlipidemia 273.0-273.8 Disorders of plasma protein metabolism 274.10-274.19 Gouty nephropathy 275.0 Disorders of iron metabolism 275.42 Hypercalcemia 276.0-276.6 Disorders of fluid, electrolyte and acid-base balance 277.3-277.4 Amyloidosis/disorders of bilirubin excretion 282.60-282.69 Sickle-cell anemia 283.11 Hemolytic-uremic syndrome 306.53 Psychogenic dysuria 344.61 Cauda equina syndrome with neurogenic bladder 401.0-405.99 Hypertensive disease 421.0-421.9 Acute and subacute endocarditis 428.0 Congestive heart failure 446.0-446.7 Polyarteritis nodosa and allied condition 447.3-447.6 Other disorders of arteries and arterioles 456.4 Scrotal varices (varicocele) 457.0-457.1 Postmastectomy lymphedema and other lymphedema 570 Acute and subacute necrosis of liver 571.40-571.49 Chronic hepatitis 571.5-571.8 Chronic and other cirrhosis of the liver 572.2 Hepatic coma 573.0-573.3 Other disorders of liver 580.0-583.9 Nephritis, nephritic syndrome, and nephrosis 584.5-584.9 Acute renal failure 585 Chronic renal failure 586 Renal failure, unspecified 587 Renal sclerosis 588.0 Renal osteodystrophy 588.1-588.8 Disorders resulting from impaired renal function 590.00-590.9 Kidney infection 591 Hydronephrosis 592.0-592.9 Calculus of kidney and ureter 593.0-593.6 Other disorders of kidney and ureter 593.70-593.73 Vesicoureteral reflux 593.81-593.89 Other specified disorders of kidney and ureter 593.9 Unspecified disorder of kidney and ureter 594.0-594.9 Calculus of lower urinary tract 595.0-595.9 Cystitis 596.0-596.4 Other disorders of bladder 596.51-596.59 Other functional disorders of bladder 596.6-596.9 Rupture of bladder, nontraumatic; hemorrhage into bladder wall; other specified bladder disorder 597.0 Urethral abscess 597.80-597.89 Other and unspecified urethritis 598.00-598.01 Urethral stricture due to infection 598.1-598.9 Urethral stricture 599.0-599.7 Other disorders of urethra and urinary tract

788.0-788.1 Renal colic/dysuria 788.20-788.29 Retention of urine 788.30-788.39 Incontinence of urine 788.41-788.43 Frequency of urination and polyuria 788.5 Oliguria and anuria 788.61-788.69 Other abnormality of urination 788.7-788.9 Urethral discharge/extravasation of urine/other symptoms involving urinary system 789.00-789.99 Other symptoms involving abdomen and pelvis 790.7 Bacteremia 790.93 Elevated PSA 791.0-791.9 Nonspecific findings on examination of urine 793.5-793.6 Abnormal findings on radiological and other examinations of genitourinary organs, abdominal area including retroperitoneum 795.79 Other and unspecified nonspecifiec immunological findings 796.2 Elevated blood pressure reading without diagnosis of hypertention 866.00-866.13 Injury to kidney 867.0-867.3 Injury to bladder and urethra 867.6 Injury to other specified pelvic organs, without mention of open wound into cavity 922.1-922.33 Contusion of trunk 922.4 Contusion to genital organs 926.0 Crushing injury of external genitalia 926.11-926.19 Crushing injury of other specified sites 926.8 Crushing injury to multiple sites of trunk 939.0 Foreign body in genitourinary tract, bladder urethra 958.5 Traumatic anuria 959.1 Injury, trunk 961.2 Poisoning by heavy metal anti-infectives 963.1 Poisoning by anti-neoplastic and immuno-suppressive drugs 963.3 Poisoning by alkalizing agents 965.1 Poisoning by salicylates 992.0-992.8 Effects of heat and light 995.2 Unspecified adverse effect of drug, medicinal and biological substance 996.30-996.39 Mechanical complication of genitourinary device, implant and graft 996.64-996.65 Infection and inflammatory reaction due to internal prosthetic device, implant and graft 996.81 Complications of transplanted kidney 997.5 Urinary complications 998.2 Accidental puncture or laceration during a procedure 999.8 Complications of medical care, not elsewhere classified; other transfusion reaction V10.46 Personal history of malignant neoplasm of prostate V10.50-V10.59 urinary organs V13.00-V13.09 Personal history of other diseases of urinary system V15.5 Injury V21.0-V21.9 Constitutional states in development V22.0-V22.2 Normal pregnancy V23.0-V23.7 Supervision of high-risk pregnancy V23.81-V23.89 Other high risk pregnancy V23.9 Unspecified high-risk pregnancy V42.0 Persons with organs or tissue replaced by kidney transplant V44.50-V44.59 Persons with cystostomy V44.6 Persons with other artificial opening of urinary tract V45.1 Renal dialysis status V58.0 Radiotherapy V58.69 Long term (current) use of other medications V67.51 Following completed treatment with high-risk medication, NEC

NON-COVERED DIAGNOSIS:

V70.0-V70.

V70.3-V70.

V76.

V81.

V81.

PRE-OPERATIVE URINALYSIS Codes V72.81-V72.84 must also have the diagnosis of the condition warranting surgery or pre-operative exam. These codes will be denied if billed alone.

MC Part B News, Oct., 2002 MC Part B News, Aug, 2000 Revises:

SP/ 2-22-