Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy
💬 Plain Language Explanation
What this means
This is a urine analysis (urinalysis). Your urine sample was tested to check for various health indicators.
Why you might see this
This is a common lab test code. You'll see it when your doctor orders a urine test, which is often done during routine check-ups, to check for infections, kidney function, or other health indicators.
Common context
Common routine lab test, often part of annual physicals or check-ups.
What to ask your provider
"'What was this urine test checking for? Was it part of my routine check-up or for a specific concern?'"
Relative Value Units (RVUs)
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Clinical Information
When to Use
Complete urinalysis with dipstick testing and microscopic examination, automated method
Common Scenarios
Documentation Requirements
- Order from physician required
- Dipstick results documented
- Microscopic findings documented
- Test results reported
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes dipstick and microscopy
- Automated method
- Complete urinalysis
Exclusions
- Do not bill non-automated urinalysis (81000) on same day
- Do not bill urinalysis without microscopy (81003) on same day
Coding Notes
Clinical scenarios
- Order from physician required
- Dipstick results documented
- Microscopic findings documented
- Order from physician required
- Dipstick results documented
- Microscopic findings documented
- Order from physician required
- Dipstick results documented
- Microscopic findings documented
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Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
National Limit: $3.17
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Ask a QuestionFrequently Asked Questions
CPT 81001 is the billing code for "Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy". Complete urinalysis with dipstick testing and microscopic examination, automated method
CPT 81001 has a total RVU of 0.60, broken down as: Work RVU 0.08, Practice Expense RVU 0.50, and Malpractice RVU 0.02. RVUs (Relative Value Units) determine Medicare reimbursement rates.
Key documentation requirements for CPT 81001 include: Order from physician required; Dipstick results documented; Microscopic findings documented; Test results reported. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 81001: Includes dipstick and microscopy. Automated method Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 81001 include: 26 (Professional component only (interpretation)), TC (Technical component only (performance)), 91 (Repeat clinical diagnostic laboratory test, same day). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 81001 is Automated testing - results typically available within hours. Time-based codes require documentation of the actual time spent providing the service.