MEDICAID CODING GUIDELINE Effective:
URINALAYSIS CPT CODES:
81000
81001 81002 81003 81005 81007 81015 81025 81050
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 automated, with microscopy non-automated, without microscopy automated, without microscopy Urinalysis, qualitative or semi-quantitative, except immunoassays Urinalysis, bacteriuria screen, by non-culture, commercial kit Urinalysis, microscopic only Urine pregnancy test, by visualcolor comparison methods Volume measurement for timed collection, each
COVERED DIAGNOSIS: 016.00-016.96 038.0-038.9 054.10-054.19 070.0-070.59 072.0 078.11 078.88 079.81-079.89 079.98 087.0-087.1 095.4 098.0 098.10-098.19 098.2 098.30-098.39 098.89 099.3 099.40-099.49 099.53-099.54 100.0 102.0-102.9 112.1 125.0-125.1 131.00-131.03 185 186.0-186.9 188.0-188.9 189.0-189.9 198.0-198.1 222.2 223.0-223.3 223.81-223.89 223.4
Tuberculosis of genitourinary system Septicemia Genital herpes Viral hepatitis Mumps orchitis Condyloma acuminatum Other specified diseases due to chlamydia infection Other specified viral and chlamydial infections Unspecified chlamydial infection Relapsing fever Syphilis of kidney Gonococcal infection, acute, lower genitourinary tract Gonococcal infection, acute, upper genitourinary tract Gonococcal infection, chronic, of lower genitourinary tract Gonococcal infection, chronic, of upper genitourinary tract Other Gonococal infection of other specified sites Reiter’s disease Nongonococcal urethritis Other venereal diseases due to Chlamydia trachomatis Leptospiral icterohemorrhagica Yaws Candidasis of vulva and vagina Filarial infection and dracontiasis Urogenital trichomoniasis Malignant neoplasm of prostate Malignant neoplasm of testis Malignant neoplasm of bladder Malignant neoplasm of kidney and other and unspecified urinary organs Secondary malignant neoplasm of kidney and other urinary organs Benign neoplasm of prostate Benign neoplasm of kidney and other urinary organs Benign neoplasm of urethra and other urinary organs Carcinoma in situ of prostate
223.7 233.9 236.5 236.7 236.90-236.99 250.00-250.93 253.5-253.6 271.4 272.2-272.4 273.0-273.8 274.10-274.19 275.0 275.42 276.0-276.6 277.3-277.4 282.60-282.69 283.11 306.53 344.61 401.0-405.99 421.0-421.9 428.0 446.0-446.7 447.3-447.6 456.4 457.0-457.1 570 571.40-571.49 571.5-571.8 572.2 573.0-573.3 580.0-583.9 584.5-584.9 585 586 587 588.0 588.1-588.8 590.00-590.9 591 592.0-592.9 593.0-593.6 593.70-593.73 593.81-593.89 593.9 594.0-594.9 595.0-595.9 596.0-596.4 596.51-596.59 596.6-596.9 597.0 597.80-597.89 598.00-598.01 598.1-598.9 599.0-599.7
Carcinoma in situ of bladder Carcinoma in situ and other unspecified urinary organs Neoplasm of uncertain behavior of prostate Neoplasm of uncertain behavior of bladder Neoplasm of uncertain behavior of other and unspecified urinary organs Diabetes mellitus Diabetes insipidus and other disorders of neurohypophysis Renal glycosuria Mixed and other unspecified hyperlipidemia Disorders of plasma protein metabolism Gouty nephropathy Disorders of iron metabolism Hypercalcemia Disorders of fluid, electrolyte and acid-base balance Amyloidosis/disorders of bilirubin excretion Sickle-cell anemia Hemolytic-uremic syndrome Psychogenic dysuria Cauda equina syndrome with neurogenic bladder Hypertensive disease Acute and subacute endocarditis Congestive heart failure Polyarteritis nodosa and allied condition Other disorders of arteries and arterioles Scrotal varices (varicocele) Postmastectomy lymphedema and other lymphedema Acute and subacute necrosis of liver Chronic hepatitis Chronic and other cirrhosis of the liver Hepatic coma Other disorders of liver Nephritis, nephritic syndrome, and nephrosis Acute renal failure Chronic renal failure Renal failure, unspecified Renal sclerosis Renal osteodystrophy Disorders resulting from impaired renal function Kidney infection Hydronephrosis Calculus of kidney and ureter Other disorders of kidney and ureter Vesicoureteral reflux Other specified disorders of kidney and ureter Unspecified disorder of kidney and ureter Calculus of lower urinary tract Cystitis Other disorders of bladder Other functional disorders of bladder Rupture of bladder, nontraumatic; hemorrhage into bladder wall; other specified bladder disorder Urethral abscess Other and unspecified urethritis Urethral stricture due to infection Urethral stricture Other disorders of urethra and urinary tract
599.81-599.89 599.9 600.0-600.9 601.0-601.9 602.0-602.9 603.0-603.9 604.0 604.90-604.91 605 606.1 607.1 607.81 607.84 607.89 608.1 608.2 608.83 608.89 608.9 616.10-616.11 618.0 619.0-619.9 625.0 625.6 625.9 628.9 634.00-634.32 635.00-635.32 636.00-636.32 637.00-637.32 638.0-638.3 639.0-639.3 642.00-642.94 646.60-646.64 647.10-347.14 648.00-648.04 648.80-648.84 654.40-654.44 669.30-669.34 672.00-672.04 710.0-710.4 710.9 711.00-711.09 714.0-714.9 719.40-719.49 724.2 724.5 752.51 753.0 753.10-753.19 753.20-753.29 753.3-753.9 780.6 780.79 782.3 785.59
Other specified disorders of urethra and urinary tract Unspecified disorders of urethra and urinary tract Hyperplasia of prostate Inflammatory diseases of prostate Other disorders of prostate Hydrocele Orchitis and epididymitis Other orchitis, epididymitis and epididymoorchitis, without mention of abscess Redundant prepuce and phimosis Oligospermia Balanoposthitis Balanitis xerotica obliterans Impotence of organic origin Other specified disorders of penis Spermatocele Torsion of testis Vascular disorders of male genital organs Other disorders of male genital organs Unspecified disorders of male genital organs Vaginitis and vulvovaginitis Genital prolapse Fistula involving female genital tract Dyspareunia Stress incontinence, female Unspecified symptom associated with female genital organs Infertility, female of unspecified origin Spontaneous abortion with complications Legally induced abortion with complications Illegally induced abortion with complications Unspecified abortion with complications Failed attempted abortion with complications Complications following abortion, ectopic and molar pregnancies Hypertension complication of pregnancy, childbirth and the puerperium Infection of genitourinary tract in pregnancy Infections and parasitic conditions in mother, Gonorrhea Other current conditions in mother, Diabetes mellitus Other current conditions in mother, Abnormal glucose tolerance Other abnormalities in shape or position of gravid uterus and of neighboring structures Acute renal failure following labor and delivery Pyrexia of unknown origin during the puerperium Diffuse diseases of connective tissue Unspecified diffuse connective tissue disease Pyogenic arthritis Rheumatoid arthritis Pain in joint Lumbago Backache, unspecified Undescended testis Renal agenesis and dysgenesis Cystic kidney disease Obstructive defects of renal pelvis and ureter Other anomalies of urinary system Fever; fever of unknown origin (FUO) Malaise and fatigue Edema Other shock without mention of trauma
788.0-788.1 788.20-788.29 788.30-788.39 788.41-788.43 788.5 788.61-788.69 788.7-788.9 789.00-789.99 790.7 790.93 791.0-791.9 793.5-793.6 795.79 796.2 866.00-866.13 867.0-867.3 867.6 922.1-922.33 922.4 926.0 926.11-926.19 926.8 939.0 958.5 959.1 961.2 963.1 963.3 965.1 992.0-992.8 995.2 996.30-996.39 996.64-996.65 996.81 997.5 998.2 999.8 V10.46 V10.50-V10.59 V13.00-V13.09 V15.5 V21.0-V21.9 V22.0-V22.2 V23.0-V23.7 V23.81-V23.89 V23.9 V42.0 V44.50-V44.59 V44.6 V45.1 V58.0 V58.69 V67.51
Renal colic/dysuria Retention of urine Incontinence of urine Frequency of urination and polyuria Oliguria and anuria Other abnormality of urination Urethral discharge/extravasation of urine/other symptoms involving urinary system Other symptoms involving abdomen and pelvis Bacteremia Elevated PSA Nonspecific findings on examination of urine Abnormal findings on radiological and other examinations of genitourinary organs, abdominal area including retroperitoneum Other and unspecified nonspecifiec immunological findings Elevated blood pressure reading without diagnosis of hypertention Injury to kidney Injury to bladder and urethra Injury to other specified pelvic organs, without mention of open wound into cavity Contusion of trunk Contusion to genital organs Crushing injury of external genitalia Crushing injury of other specified sites Crushing injury to multiple sites of trunk Foreign body in genitourinary tract, bladder urethra Traumatic anuria Injury, trunk Poisoning by heavy metal anti-infectives Poisoning by anti-neoplastic and immuno-suppressive drugs Poisoning by alkalizing agents Poisoning by salicylates Effects of heat and light Unspecified adverse effect of drug, medicinal and biological substance Mechanical complication of genitourinary device, implant and graft Infection and inflammatory reaction due to internal prosthetic device, implant and graft Complications of transplanted kidney Urinary complications Accidental puncture or laceration during a procedure Complications of medical care, not elsewhere classified; other transfusion reaction Personal history of malignant neoplasm of prostate urinary organs Personal history of other diseases of urinary system Injury Constitutional states in development Normal pregnancy Supervision of high-risk pregnancy Other high risk pregnancy Unspecified high-risk pregnancy Persons with organs or tissue replaced by kidney transplant Persons with cystostomy Persons with other artificial opening of urinary tract Renal dialysis status Radiotherapy Long term (current) use of other medications Following completed treatment with high-risk medication, NEC
NON-COVERED DIAGNOSIS: V70.0-V70.1 V70.3-V70.9 V76.3 V81.5 V81.6
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/ 2-22-02
