Understanding CPT Code Changes for Urine Culture Testing in 2021
As we approach the end of 2021, healthcare providers are getting ready for a big change in CPT codes for urine culture testing. The new codes will provide more specificity and accuracy in reporting this important diagnostic test. In this blog post, we will delve into the CPT code changes for urine culture testing and what they mean for healthcare providers.
What are CPT codes?
CPT codes, or Current Procedural Terminology codes, are five-digit codes used by healthcare providers to report medical procedures and services to insurance companies. They ensure that medical procedures and services are accurately reported and receive the appropriate payment. CPT codes are updated annually by the American Medical Association (AMA) to reflect changes in medical technology, terminology, and practice.
The changes in CPT codes for urine culture testing
The most significant change in CPT codes for urine culture testing in 2021 is the addition of four new codes: 87015, 87040, 87045, and 87046. These codes are intended to provide more specificity in reporting cultures, including microscopic examination and antibiotic susceptibility.
Previously, healthcare providers reported urine culture testing using a single code, 87086. This code covered the entire process, from culture growth and identification to antibiotic susceptibility testing. However, it lacked specificity in reporting the individual components of the test.
With the addition of the new codes, healthcare providers can report the individual components of the urine culture testing process, including the growth of cultures, the examination of cultures microscopically, and the assessment of antibiotic susceptibility. This increased specificity in reporting will benefit both healthcare providers and insurance companies in determining appropriate payment for the services provided.
How do the changes affect healthcare providers?
The changes in CPT codes for urine culture testing will require healthcare providers to update their billing practices. They will need to ensure that they are using the correct codes and that they are reporting all components of the test accurately. This may require additional training and education for billing and coding staff.
It is also crucial that healthcare providers communicate with their payers to ensure that they are aware of the changes and how they will affect reimbursement. It is recommended that providers check with their payers to confirm that the new codes are recognized and that they will be reimbursed appropriately for the services provided.
Conclusion
The changes in CPT codes for urine culture testing in 2021 provide more specific reporting of the components of the test. This change will improve accuracy in reporting, which will benefit both healthcare providers and insurance companies. Healthcare providers must ensure that they are using the correct codes and that they are reporting all components of the test accurately to ensure appropriate reimbursement. As always, providers should communicate with their payers to ensure that they are aware of the changes and how they will be affected.
