tci ED Coding & Reimbursement Alert - 2005 Issue 8

Reader Questions: Obtain Doctor's Findings for UA

Question: When we code a urinalysis (UA), the lab template says, "culture if indicated." We report the diagnosis the doctor gave for the UA at the start. However, the lab manager wants us to code the reason for the culture based on the UA findings, because the claims often get denied. There is a code for abnormal UA findings, but I have been trying to explain to her that we cannot code off of the UA results without the physician's interpretation of them. She argued that there is a criterion in place as to when to perform...

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