2025 CPT code 81001
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Urinalysis Procedures Pathology and Laboratory Feed
Automated urinalysis using a dipstick or tablet reagent, including microscopy.
Modifiers may apply depending on the specific circumstances of service (e.g., QW for CLIA-waived tests). Consult the CPT manual for detailed information on modifier usage.
Medical necessity for a urinalysis is established when the physician has a clinical indication to evaluate for a specific condition, monitor the progression of disease, or screen for potential problems based on patient symptoms, risk factors, or ongoing health management.This must be documented in the medical record.
Clinical laboratory personnel are responsible for performing the test accurately and reporting results to the ordering physician. The physician is responsible for ordering the test appropriately, interpreting the results, and incorporating findings into the patient's overall care plan.
In simple words: This lab test checks a urine sample using a special strip or tablet to look for different things that might indicate a problem.It also includes looking at the urine sample under a microscope.
This code reports an automated urinalysis employing a dipstick or tablet reagent method.The analysis includes the assessment of bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, and urobilinogen, or any combination thereof.Microscopic examination of urine sediment is also performed.
Example 1: A patient presents with symptoms suggestive of a urinary tract infection (UTI). The physician orders a complete urinalysis (81001) to evaluate for the presence of bacteria, white blood cells, and other indicators of infection., A patient undergoes a routine physical examination, including urinalysis.The automated urinalysis (81001) with microscopy is performed to screen for any underlying metabolic abnormalities or kidney issues., A patient with known diabetes mellitus is being monitored for kidney disease. The physician orders a urinalysis (81001) to assess for the presence of proteinuria (protein in the urine) as an indicator of nephropathy.
** Always refer to the most current CPT codebook and payer guidelines for the most up-to-date coding information.Understanding payer-specific rules and local coverage determinations (LCDs) is crucial for accurate billing and reimbursement.
- Revenue Code: T1C (LAB TESTS - URINALYSIS)
- RVU: RVUs vary based on geographic location and payer; consult a relevant fee schedule for the current values.
- Global Days: Not applicable to this laboratory code.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to this code as it refers to the complete urinalysis procedure.
- Fee Schedule: Fee schedules vary based on geographic location, payer, and year.Consult historical fee schedules from appropriate payers for past payment data.
- Specialties:Urology, Nephrology, Internal Medicine, Family Medicine, Pediatrics
- Place of Service:Office, Hospital (Inpatient and Outpatient), Laboratory, Urgent Care Facility, Other