# E&M and urinalysis codes



## reneedanielle22  (Sep 15, 2014)

I have had a problem with Medicare saying claims aren't covered with e&m codes with urinalysis codes 81003,QW and 82570,QW. They are supposed to be covered at our practice so I'm not sure why we have gotten quite a few denials.

For example: 99213,25 51798 81003,QW 82570,QW 

These codes keep kicking back with not covered but they are. Am I suppose to attach the Labs with it? When I attached the lab report I got it paid. But there is someone in the office questioning why I am attaching labs to the urines when they never did that before. If anyone has had this problem please let me know.


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## trinalankford (Sep 15, 2014)

Are you sure that is the reason for the denial?  We are paid for 81000 urinalysis (the only one we do in-office) and E/M codes.  We are starting to notice Medicare denials for 81000 and E/M but for the reason of "no medical necessity."  This is especially true in the case of prostate CA or elevated PSA.  Those are being denied.


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## emcee101 (Sep 16, 2014)

*Modifier 25 Usage*

Since 51798, 81003 and 82570 all carry a XXX global status (global period does not apply), it could be kicking back because you're using a 25 modifier when it probably is not needed. I see no other reason why it would be denied.


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