Wiki Payment for 81002

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dballard2004

True Blue
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Overland Park, KS
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We have a problem with one of our carriers bundling a UA (CPT code 81002) into the E/M. This is a recent change and none of our payors do this unless we have specifically contracted for a visit rate, so this is not industry standard. Can anyone point me in the direction of a Medicare payment policy or any other proof of industry standard being separate payment for this code?
 
I also have a coworker who came to me this morning with this issue. A private insurance company and medicaid are actually bundling UA and CBC with the office visit. Can you help me?
 
81002

Does Medicare pay for 81002 along with the office visit code of 99214? if so do we need to put any modifier? we are getting denials from medicare, please help, we are a primary care physician office:)
 
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