Primary Care Coding Alert

Question: Is a urinalysis (screening) included in or bundled with a patient's initial preventive physical exam or annual wellness visit?Indiana SubscriberAnswer: Medicare does not cover a screening urinalysis. Medicare coverage of a urinalysis depends upon the patient having a symptom supporting medical necessity (such as burning during urination). If you routinely perform a screening urinalysis in conjunction with your initial preventive physical exam (i.e., Welcome to Medicare visit) or annual preventive screenings, ask the patient to sign at Advance Beneficiary Notice (ABN) beforehand to cover the screening, which is a separately reportable service.When treating non-Medicare patients, check the payer's policy before seeing the patient. You might need to ask the patient to sign an ABN-type acknowledgement to receive payment. Again, from a coding perspective, a screening urinalysis is not considered part of a preventive medicine visit service (codes 99381-99397) and should be reported separately, if performed.