Laboratory Question for the Week of August 13, 2018

Laboratory Compliance Question of the Week

Question:

Does CMS provide a list of the conditions that it considers medically necessary for a urinalysis?

Answer:

There are many examples of when urinalysis is considered medically necessary by the Medicare Program. However, the best thing is to verify coverage of pre-operative testing with the individual payers. Most payers have reimbursement policies and list the tests that are non-covered when ordered as a screening procedure prior to surgery.

Also remember to document lab tests with signs and symptoms or ICD-10 information concerning the reason the test is being performed, not the post-test diagnosis. It is inappropriate for laboratory personnel to use post-test diagnosis for addition of reflex tests unless the treating physician has reviewed the initial result and provided in writing the additional diagnosis.


This question was answered in the 2018 edition of our Coding Essentials for Laboratories. For more hot topics relating to laboratory services, please view our store, or call us at 1.800.252.1578 ext. 2.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.