CPT 81025, 81025 cpt code, cpt code 81025

CPT Code 81025 | Description, Procedure & Billing Guidelines (2022)

The 81025 CPT code is used for billing pregnancy tests by visual color comparison. Below are the description, procedure, and billing guidelines for this code. 

1. What Is CPT Code 81025?

CPT 81025 covers a pregnancy test performed by a lab analyst to test a urine specimen with a kit or a methodology that shows the results visually.

2. Description

The CPT book describes CPT 81025 as follows: “Urine pregnancy test, by visual color comparison methods.”

3. Procedure

The 81025 CPT code procedure is performed to determine the results of a pregnancy test (positive or negative) by analyzing specimens from the patient (preferably first-morning urine).

A lab analyst starts this procedure by performing the technical steps needed to determine if someone is pregnant.

One of the most common methods is dipstick strips with reagents that will react to pregnancy hormones in the patient’s urine.

The result of this pregnancy test visually shows a color change. The lab analyst interprets this. The results can either be positive (pregnant) or negative (not pregnant).

The more concentrated the urine, the more reliable the results are. Therefore, the first-morning urine is preferred for the best results.

4. Billing Guidelines

Clinicians often use the rapid pregnancy test described by CPT 81025 to determine the pregnancy of a patient still in the office. In addition, it is often used before imaging procedures that could harm a baby.

Check CPT 84702 or CPT 84703 for more precise pregnancy tests.

This is a female-only code.

4.1 Does CPT Code 81025 Need A Modifier?

CPT 81025 does not need a modifier to be recognized as a CLIA-waived test.

5. Resources

CPT Professional 2022

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM10819.pdf

https://www.aapc.com/codes/coding-newsletters/my-ob-gyn-coding-alert/obstetrics-start-the-new-year-by-perfecting-your-global-maternal-care-packages-start-date-159558-article

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