How To Use CPT Code 81005

CPT 81005 describes the procedure for urinalysis, specifically for qualitative or semiquantitative analysis, excluding immunoassays. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 81005?

CPT 81005 is used to describe the procedure for urinalysis, specifically for qualitative or semiquantitative analysis. This code is not applicable for immunoassays. It is used when the lab analyst measures a requested analyte in a urine specimen and reports the results as qualitative or semiquantitative. The test does not apply to immunoassay methodology, which detects an antigen-antibody reaction.

2. Official Description

The official description of CPT code 81005 is: ‘Urinalysis; qualitative or semiquantitative, except immunoassays.’

3. Procedure

1. The lab analyst performs the technical steps to qualitate or semiquantitate the ordered analyte in a urine specimen.
2. The methodology used varies depending on the requested analyte.
3. Qualitative analysis refers to detecting the presence or absence of the analyte, while semiquantitative analysis provides a less precise measurement than a quantitative measurement.
4. This code does not apply if the analyst uses immunoassay methodology, which detects an antigen-antibody reaction.

4. Qualifying circumstances

CPT 81005 is not limited to testing for a specific condition. However, it may be ordered by a clinician on an infant suspected of having galactosemia, a rare genetic defect that affects the metabolism of galactose. This test reveals the qualitative presence of reducing substances in the urine.

5. When to use CPT code 81005

CPT code 81005 should be used when a clinician orders a urinalysis for qualitative or semiquantitative analysis, excluding immunoassays. It is important to note that this code does not apply to immunoassay methodology.

6. Documentation requirements

To support a claim for CPT 81005, the documentation should include:

• The specific analyte being tested
• The methodology used for the analysis
• The date and time of the test
• The results of the qualitative or semiquantitative analysis

7. Billing guidelines

When billing for CPT 81005, ensure that the test is performed for qualitative or semiquantitative analysis, excluding immunoassays. It is important to follow the specific guidelines provided by the payer regarding the appropriate use of this code. Additionally, consider any applicable modifiers or other codes that may need to be reported in conjunction with CPT 81005.

8. Historical information

CPT 81005 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A clinician orders a urinalysis for qualitative analysis to detect the presence of reducing substances in the urine of an infant suspected of having galactosemia.
2. A lab analyst performs a semiquantitative urinalysis to measure the levels of a specific analyte in a patient’s urine sample.
3. A clinician orders a urinalysis for qualitative analysis to detect the presence of certain substances in the urine that may indicate a specific condition.
4. A lab analyst performs a qualitative urinalysis to determine the presence or absence of a particular analyte in a patient’s urine sample.
5. A clinician orders a semiquantitative urinalysis to obtain a less precise measurement of a specific analyte in a patient’s urine sample.
6. A lab analyst performs a qualitative urinalysis to detect the presence or absence of certain substances in a patient’s urine sample.
7. A clinician orders a urinalysis for semiquantitative analysis to obtain a rough measurement of a specific analyte in a patient’s urine sample.
8. A lab analyst performs a qualitative urinalysis to identify the presence or absence of reducing substances in a patient’s urine sample.
9. A clinician orders a semiquantitative urinalysis to obtain a less precise measurement of a specific analyte in a patient’s urine sample.
10. A lab analyst performs a qualitative urinalysis to detect the presence or absence of a particular analyte in a patient’s urine sample.