2025 CPT code 81099
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Laboratory - Urinalysis Procedures Pathology and Laboratory Feed
Unlisted urinalysis procedure; use when no other specific CPT code applies.
Modifiers may be applicable depending on the specific circumstances and payer requirements.Consult payer guidelines for appropriate modifier usage.
Medical necessity must be established by the ordering physician through appropriate documentation of symptoms, signs, or other clinical findings supporting the need for the unlisted urinalysis procedure.
The clinical responsibility lies with the laboratory personnel who perform the analysis and interpret the results. The ordering physician is responsible for medical decision-making based on the lab results.
In simple words: This code is for any urine test that doesn't have its own specific code. The lab might mix the urine with chemicals, look at it under a microscope, or use other methods to test it.
This CPT code, 81099, represents an unlisted urinalysis procedure.It is used to report any urinalysis performed that does not have a specific CPT code.The procedure may involve various techniques such as chemical reactions, microscopic examination with dyes, or other methods applied to urine specimens (random, catheterized, clean catch, first morning, or timed collections).
Example 1: A patient presents with symptoms suggestive of kidney stones. The physician orders a comprehensive urinalysis including microscopic examination for crystals and cells, along with various chemical analyses not specifically covered by other CPT codes. Code 81099 would be used to report this., A research study requires analysis of specific urinary biomarkers not routinely measured in standard urinalysis.The laboratory develops a new analytical method and uses 81099 to bill for this unique procedure., A patient with suspected drug abuse undergoes a urinalysis to detect the presence of a newly developed synthetic opioid.Since no specific CPT code exists for this drug, 81099 is used to report the testing.
Detailed description of the performed urinalysis procedure, including all performed tests; specific methodologies employed; results of all tests and analysis; and a clear explanation of why this unlisted code is necessary instead of a more specific CPT code.Detailed information of the type of specimen obtained (e.g., random, timed, first morning) should also be included.
- Revenue Code: T1C (LAB TESTS - URINALYSIS)
- RVU: The relative value units (RVUs) for this code will vary depending on factors such as the complexity of the test, geographic location, and payer.It's crucial to consult the specific payer's fee schedule for accurate reimbursement information.
- Global Days: Not applicable; this is a laboratory procedure, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Historical fee schedule information is not readily available and varies widely across payers and geographic regions.Consult specific payer fee schedules for historical data.
- Specialties:Clinical Laboratory
- Place of Service:Laboratory