Wiki Comprehensive UTI panel

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heatherd

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Can anyone compare a comprehensive UTI panel's code set with ours?
I'm trying to paste a copy of the panel, will try in the comments.
We've got 87481 x5 , 87500 , 87640 , 87641 , 87653 , and 87798 x13.

I would LOVE any thoughts!! Thanks!!
 
PATHOGENS:
Acinetobacter baumannii
Actinobaculum schaalii
Aerococcus urinae
Candida albicans
Candida glabrata
Candida tropicalis
Candida parapsilosis
Candida krusei
Citrobacter freundii
Citrobacter koseri
Corynebacterium urealyticum
Enterobacter cloacae complex
Enterococcus faecalis
Enterococcus faecium
Escherichia coli
Klebsiella (Enterobacter) aerogenes
Klebsiella oxytoca
Klebsiella pneumoniae
Morganella morganii
Pantoea agglomerans
Proteus mirabilis
Proteus vulgaris
Providencia stuartii
Pseudomonas aeruginosa
Serratia marcescens
Staphylococcus aureus
Staphylococcus epidermidis
Staphylococcus saprophyticus
Streptococcus agalactiae
Streptococcus anginosus
 
Antibiotic Resistance Genes
[CPE], [ESBL], [VRE]
CTX-M
Imipenemase (IMP)
Klebsiella pneumoniae carbapenemase (KPC)
New Delhi Metallo-beta-lactamase (NDM)
Verona Integron-encoded Metallo-β-Lactamase (VIM)
Oxacillinase-48 (OXA-48)
vanA
vanB
MRSA- SA, mecA, mecC
 
Hello heatherj;
I so do apologize that reviewing this for over an hour I wasn't able to identify the correct CPT assignment in your questions this evening.
So, may I simply offer some advice please?
When I review your scenario - was this comprehensive UTI panel performed "in house" - did your facility perform it OR WAS THIS a send out to another facility and if so, which one?
I am so excited that you are questioning and validating all these charges!! I would be too!!
The only reason I am asking is that whoever ran this urinalysis testing possibly has a "lab catalog" to review and support billing all these charges. I have had plenty of laboratory denials especially on a send out specimen that I relied on the information from where we sent it to and their facility along with their catalog to validate that is why we are billing the charges we are. Most coders don't know of this ability to google their facility and find the laboratory or pathology, or cytogenetics or molecular testing performed at their facility. I utilize this tool for every client I work for to ensure accurate coding. With 13 charges for 87798 CPT code - you may still have some hurdles even though it wasn't past the MUE (medical unlikely threshold). Keep doing what you are doing and question and absorb it all. You are doing a fantastic job in my opinion.
Have a fantastic evening,
Dana Chock, CPC, CANPC, CHONC, CPMA, CPB, RHIT
 
Hi HeatherJ, The below coding is perfect

Can anyone compare a comprehensive UTI panel's code set with ours?
I'm trying to paste a copy of the panel, will try in the comments.
We've got 87481 x5 , 87500 , 87640 , 87641 , 87653 , and 87798 x13.
 
I know this is a rather old post, but I would like to point that a laboratory panel should not be unbundled. Please see Medicare and Medicaid NCCI edit Manuals Chapter 10. In the introduction section it states:
"If a laboratory procedure produces multiple reportable test results, only a single HCPCS/CPT
code shall be reported for the procedure. If there is no HCPCS/CPT code that describes the
procedure, the laboratory shall report a miscellaneous or unlisted procedure code with a single
unit of service."

Medicaid NCCI Policy Manual | CMS

www.cms.gov www.cms.gov

Medicare NCCI Policy Manual | CMS

www.cms.gov www.cms.gov
See also LCD L38988 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

​

 
srgarrick said:
"If a laboratory procedure produces multiple reportable test results, only a single HCPCS/CPT
code shall be reported for the procedure. If there is no HCPCS/CPT code that describes the
procedure, the laboratory shall report a miscellaneous or unlisted procedure code with a single
unit of service."
Click to expand...
Hello,
so her panel should be billed as 87481 x1 , 87500x1 , 87640x1 , 87641x1 , 87653x1 , and 87798 x13 or 13 separate lines of 87798. Agree?

Thank you.
Daniela P.

srgarrick said:
I know this is a rather old post, but I would like to point that a laboratory panel should not be unbundled. Please see Medicare and Medicaid NCCI edit Manuals Chapter 10. In the introduction section it states:
"If a laboratory procedure produces multiple reportable test results, only a single HCPCS/CPT
code shall be reported for the procedure. If there is no HCPCS/CPT code that describes the
procedure, the laboratory shall report a miscellaneous or unlisted procedure code with a single
unit of service."

Medicaid NCCI Policy Manual | CMS

www.cms.gov www.cms.gov

Medicare NCCI Policy Manual | CMS

www.cms.gov www.cms.gov
See also LCD L38988 MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

​

Click to expand...
 
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