Coding Coach: Capture Urine Culture Payment With These Best Practices

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains how urine culture-related testing is discussed in the context of urology office billing, Medicare coverage guidance, and laboratory follow-up studies. It is intended for coders, billers, and practice staff who need a better understanding of the test categories, supporting documentation themes, and related coverage considerations discussed in the source.

Why This Topic Matters

Urine culture services are common, and understanding the article’s scope can help readers evaluate whether it addresses coding, documentation, and coverage issues relevant to their practice.

Article Sections

  1. Do: Let Test Specifics Guide Code Choice

    Introduces urine culture testing in the urology setting and discusses how test characteristics and coverage guidance affect code selection at a broad level.

  2. Save 87088 for Positively Identified Bacterial Growth

    Covers follow-up laboratory reporting considerations after an initial urine culture and the documentation context associated with reporting additional testing.

  3. Positive Cultures May Require Further Testing

    Summarizes additional urine susceptibility testing options that may be considered after a positive culture result.

  4. Refer to the NCD for Guidance

    Reviews Medicare coverage guidance themes and the broad types of clinical indications described for urine culture studies.

What You Will Learn

  • How the article frames urine culture testing in relation to coding and reimbursement
  • What broad categories of urine culture and follow-up testing are discussed
  • How Medicare coverage guidance and documentation themes are presented
  • Which specialties and practice settings the article is aimed at

Who Should Read This

  • Medical coders
  • Billing staff
  • Urology practice managers
  • Clinical documentation staff
  • Laboratory billing personnel

Codes Discussed

  • CPT: 87086
  • CPT: 87088
  • CPT: 87081
  • CPT: 87184
  • CPT: 87186
  • ICD-9-CM: 788.41
  • ICD-9-CM: 788.1
  • ICD-9-CM: 780.6
  • ICD-9-CM: 599.0

Modifiers Discussed

  • CPT: 59

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