Question

question 20

what is the code and any required modifier(s) for dipstick urinalysis, automated, without microscopy performed in a physician office for a medicare patient?

81001
81000-26-qw
81003-qw
81002-26-qw

Explanation:

Identify the correct CPT code for automated urinalysis without microscopy

The procedure is "dipstick urinalysis, automated, without microscopy."

• CPT 81002 represents urinalysis, by dip stick or tablet reagent... non-automated, without microscopy.
• CPT 81003 represents urinalysis, by dip stick or tablet reagent... automated, without microscopy.

Determine the required modifier for a Medicare patient in a physician office

• The test is performed in a physician's office laboratory (POL) which typically operates under a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver.
• For Medicare patients, services that are CLIA-waived must be billed with the modifier -QW (CLIA waived test) to ensure reimbursement.
• Modifier -26 (professional component) is not appropriate because the physician office performed the complete (global) test, not just the professional interpretation.

Select the matching option

Combining CPT code 81003 with modifier -QW yields 81003-QW.

Answer:

• (A) 81001
• (B) 81000-26-QW
• (C) 81003-QW (Correct answer)
• (D) 81002-26-QW