[MT-L] Urinalysis and microscopic review

[Looker, Julee]

We have recently been informed that we cannot bill for a urinalysis and a microscopic under our current set up. How does everyone else do their urinalysis? We do have a separate ua for our ER patients that auto reflex a microscopic if needed, but we haven't made this available to our inpatients and outpatients at this time. I am interested in finding out what your process is and what CPT codes you use. Thanks for any info you can share.

Julee Looker, MLS(ASCP)
LIS Coordinator
Logansport Memorial Hospital
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[Birkenholz, Karen]

We offer a UAPRNMIC which is a dipstick that will reflex a microscopic if needed. The CPT code for that one is 81003. If it meets the criteria for a microscopic it actually cancels that test and orders a UAMIC which has a CPT code of 81001. We also offer a UAPRNCULT which is a ua with microscopic and it reflexes a culture if needed. That one also has a CPT code of 81001.

Thank you,
Karen Birkenholz, MT(ASCP)
LIS Analyst
Norman Regional Laboratory Services
phone: 405-307-1135
pager: 405-327-0774

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[Tim Wilkins]

Julee,

I have set up the same thing that Karen has. Medicare will only for one or
the other. The other way to do this is with a charge rule that if no
microscopic ordered then use one bill code, but if the system sees a
microscopic it uses that bill code instead.

Thanks,

Tim
Tim Wilkins, BS MT(ASCP), MBA
Senior Consultant, MEDITECH Services
Santa Rosa Consulting, Inc.

[Paul Goedicke]

Tim, the only problem with urines now is most labs are reflexing the microscopic based on dipstick results. After the initial dipstick order is filed, a charge rule cannot be used to charge for a complete urinalysis if the microscopic is needed. It's a similar situation with cbc's. Another option, however, is to use a claim map that submits the correct cpt when the two separate cpt's are on the claim. Keeps out of trouble with Medicare anyway.
Paul

Paul Goedicke
Clinical Analyst III
Jackson County Memorial Hospital
1200 E. Pecan Street
Altus, OK 73521
Phone (580) 379-5565
Fax (580) 379-5559
paulgo...@jcmh.com
"Don't take life too seriously, you won't get out alive."

Julee,

Thanks,

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[Bruce Joy]

We set up an additional test "Microscopic" that is required to be
answered with a yes or no. We attach the charge based on the answer to
the question, rather than at the actual urinalysis order.

Bruce Joy

[Paul Goedicke]

That's also our current process, and fortunately, our FI does not have a medical necessity policy on UA's, but for those that do, how are you triggering the medical necessity check at a time when the patient and diagnostic information are present? When I left Iowa, our FI there had local policies on UA's.
Thanks,
Paul

Bruce Joy

Julee,

Thanks,

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[Tim Wilkins]

Julee,

As Paul and Bruce have brought up, there is always more than one way to get
things done in MEDITECH. Both are also good solutions to the issue. I have
not run into the issue that Paul brought up with the carge rule on dispstick
results. I have always understood that the charge did not actually post to
BAR until midnight. I have used a combination of a reflex order group that
is attached to a "IS MICRO REQUIRED" test and a charge rule on the UA.

Here is the charge rule that I have used.

IF{(UMIC) [f lord use bill code]("bill code for UAMIC");[f lord bill code]};

Thanks,

Tim
Tim Wilkins, BS MT(ASCP), MBA
Senior Consultant, MEDITECH Services
Santa Rosa Consulting, Inc.

-----Original Message-----
From: Bruce Joy [mailto:Bruc...@flaglerhospital.org]
Sent: Wednesday, August 03, 2011 1:44 PM