2025 CPT code 81003
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Laboratory - Urinalysis Procedures Pathology and Laboratory Feed
Automated urinalysis using dipstick or tablet reagent, without microscopy, for various constituents.
Modifiers such as 59 (distinct procedural service), 90 (reference lab), 91 (repeat test), and others may apply depending on the specific circumstances. Consult the CPT manual and payer guidelines for appropriate modifier usage.
Medical necessity for a urinalysis is typically established based on the presence of symptoms or signs suggestive of various conditions (e.g., UTI, kidney disease, diabetes, etc.) or as part of a routine screening or assessment.
A laboratory analyst performs this test. Their responsibilities include collecting the specimen, performing the automated analysis using a dipstick reader or other automated method, and reporting the results. Clinicians order the test based on patient symptoms or as part of a routine checkup.
In simple words: This lab test checks a urine sample for different things like sugar, protein, and infection signs using a special machine.It doesn't include a detailed look under a microscope.
This CPT code (81003) represents an automated urinalysis performed using either a dipstick or tablet reagent.The analysis includes, but is not limited to, the following constituents: bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, and urobilinogen. Microscopy is not included in this procedure. The test is conducted using an automated dipstick reader which reports results semi-quantitatively (trace, 1+, 2+, 3+, 4+) or quantitatively (mg/dL, pH units, specific gravity).Note that while tablet reagents are technically included in the code, their use in automated systems is practically obsolete.
Example 1: A patient presents with symptoms suggestive of a urinary tract infection (UTI).The physician orders a urinalysis (81003) to check for the presence of leukocytes, nitrite, and other indicators of infection., A patient undergoes a routine physical examination. As part of the assessment, a basic urinalysis (81003) is performed to screen for potential metabolic disorders, such as diabetes (glucose detection)., A patient with known kidney disease is monitored regularly. A urinalysis (81003) is ordered to assess kidney function by checking for proteinuria and other indicators.
* Physician's order specifying the required urinalysis.* Properly labeled urine specimen with collection date and time.* Laboratory report with quantitative and/or semi-quantitative results for all tested analytes.* Documentation of the method used (automated dipstick/tablet reagent analysis).
** Always verify coding with the most recent CPT manual and payer-specific guidelines.Be mindful of potential unbundling issues when reporting this code with other urinalysis or related procedures.
- Revenue Code: T1C (LAB TESTS - URINALYSIS)
- RVU: The RVUs for this code will vary based on geographic location, payer, and other factors. Consult your local fee schedule or payer guidelines for specific RVU values and reimbursement rates.There is no single, universally applicable RVU value.
- Global Days: Not applicable. This is a single-procedure code with no inherent global surgical period.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier does not apply to this code because the test is performed in a laboratory setting.
- Fee Schedule: The historical fee schedule for 81003 is not available in this context.Fee schedules vary by payer and geographic location, and historical data is usually accessible through specific payer databases or billing software.
- Specialties:Urology, Nephrology, Internal Medicine, Family Medicine, Pediatrics, Pathology
- Place of Service:Office, Laboratory, Hospital (inpatient or outpatient), Urgent Care, other clinical settings where laboratory services are provided