Urology Coding Alert

Question: I'm wondering about CPT Code 87081, urine screen culture. What are the requirements for this procedure? Which diagnoses are acceptable?

New York Subscriber

Answer: The urinary culture screening for bacterial growth, 87081 (Culture, presumptive, pathogenic organisms, screening only), consists of a sterile slide with growth media on either side to support growth of Gram positive and Gram negative organisms. The urologist dips the slide into the urine, places it in a small sterile container and places the container in an incubator for 24 hours. Any subsequent growth is recorded and then sent to the laboratory for bacterial identification and antibiotic sensitivities.

Many diagnoses are available to ensure payment, such as urinary symptoms (788.x); fever (780.6); and nephritis, nephritic syndrome and nephrosis (580-589).

Opportunity: Remember that 87081 may be used in any office registered with a minimal CLIA certificate. However, in offices with a higher CLIA certificate, the urologist may use 87086 (Culture, bacterial; quantitative colony count, urine), and if the test is positive, he may use 87088 (... with isolation and presumptive identification of isolates, urine) and 87184 (Susceptibility studies, antimicrobial agent; disk method, per plate [12 or fewer agents]). Carriers usually reimburse these latter three studies at a slightly higher rate than 87081, reflecting their increased laboratory complexity and the extra work involved.