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81003

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, without microscopy

Pathology & Laboratory Urinalysis 0.41 Total RVUs
Quick Reference
Urinalysis with dipstick testing only, without microscopic examination, automated method

Relative Value Units (RVUs)

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Work RVU
0.05
Physician effort
PE RVU
0.35
Practice expense
MP RVU
0.01
Malpractice
Total RVU
0.41
Combined value
Dollar reimbursement rates vary by locality and payer. RVUs shown for relative comparison only.
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Clinical Information

When to Use

Urinalysis with dipstick testing only, without microscopic examination, automated method

Time Requirement
Automated testing - results typically available quickly

Common Scenarios

Routine urinalysis screening with automation
Dipstick urinalysis only
Quick automated urinalysis without microscopy
Pre-operative urinalysis screening
Basic automated urinalysis

Documentation Requirements

  • Order from physician required
  • Dipstick results documented
  • Test results reported

Coding Guidelines

Common Modifiers

26 Professional component only (interpretation)
TC Technical component only (performance)
91 Repeat clinical diagnostic laboratory test, same day

Bundling Rules

  • Includes dipstick only
  • Automated method
  • No microscopy

Exclusions

  • Do not bill urinalysis with microscopy (81001) on same day
  • Do not bill non-automated urinalysis (81002) on same day

Coding Notes

Basic urinalysis without microscopy
Automated method
Common screening test

Clinical scenarios

Routine urinalysis screening with automation
Routine urinalysis screening with automation
When to use:Urinalysis with dipstick testing only, without microscopic examination, automated method
  • Order from physician required
  • Dipstick results documented
  • Test results reported
Dipstick urinalysis only
Dipstick urinalysis only
When to use:Urinalysis with dipstick testing only, without microscopic examination, automated method
  • Order from physician required
  • Dipstick results documented
  • Test results reported
Quick automated urinalysis without microscopy
Quick automated urinalysis without microscopy
When to use:Urinalysis with dipstick testing only, without microscopic examination, automated method
  • Order from physician required
  • Dipstick results documented
  • Test results reported

Who are you?

Code Details

Code 81003
Category Pathology & Laboratory
Subcategory Urinalysis
Total RVUs 0.41

Medicare Pricing

PFS
2025 National Rate
$0.00
Facility
$0.00
Non-Facility
$0.00
RVU Breakdown
Work RVU:0.00PE RVU:0.00MP RVU:0.00Total RVU:0.00CF:$32.3465Global Days:XXX
OPPS Details
Status:Q4Copayment:$0.00

National Limit: $2.25

Physician Fee Schedule: Medicare pays physicians based on Relative Value Units (RVUs) multiplied by a conversion factor.

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Frequently Asked Questions

What is CPT code 81003?

CPT 81003 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, without microscopy". Urinalysis with dipstick testing only, without microscopic examination, automated method

What are the RVUs for CPT 81003?

CPT 81003 has a total RVU of 0.41, broken down as: Work RVU 0.05, Practice Expense RVU 0.35, and Malpractice RVU 0.01. RVUs (Relative Value Units) determine Medicare reimbursement rates.

What documentation is required for CPT 81003?

Key documentation requirements for CPT 81003 include: Order from physician required; Dipstick results documented; Test results reported. Missing or incomplete documentation is a leading cause of claim denials for this code.

Can CPT 81003 be billed with other codes?

Bundling considerations for CPT 81003: Includes dipstick only. Automated method Use an NCCI bundling checker to verify specific code combinations before billing.

What modifiers are commonly used with CPT 81003?

Common modifiers for CPT 81003 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.

What is the time requirement for CPT 81003?

The typical time requirement for CPT 81003 is Automated testing - results typically available quickly. Time-based codes require documentation of the actual time spent providing the service.

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