Ugh. Blue Shield is doing a thing with the 81002.

This may just be Blue Shield of California, I am not sure, but they have been bundling my urine dips (81002) into the office visit recently. 

 

So, public service announcement, bill your UAs to Blue Shield with a 25 modifier on the office visit and a 59 modifier on the 81002 as in the example below.

 

B34.4             Z68.28                 Z51.89                                99213 – 25

R10.9                                                                                      81002 – 59 

 

Also make sure that your code is set up to be a “lab” code and that your CLIA prints on it properly. Some of my providers have run into issues with that. 

Questions? Comments? Criticism? Glowing emails as to how I have saved your office from certain destruction? Please direct those to (909) 610-9524 or newgenerationbilling@gmail.com

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4 Comments

Filed under Blue Shield, Medical Billing, Office Visit, Urinalysis

4 responses to “Ugh. Blue Shield is doing a thing with the 81002.

  1. Jeni Turnbell

    Hi! Try billing the 81003. They have been paying that code only in michigan. They updated the fee schedule here in 2017 and deleted the 81002 code. Let me know if this works for ya. JLT

    • Thank you! My providers haven’t been using that because the description states that test is automated. I am not sure what that means, so they were coming down on the safe side. What would be the difference between an automated and non-automated urinalysis? If any other readers know or want to chime in, please do so.

      • Jeni Turnbell

        You are explaining a non-automated UA without microscopy – 81002 would be the correct code.

        When it comes to UAs it is all about the method of analysis and the use of a microscope for further analysis.

        non-automated testing (81000 and 81002) is done by dipping the dipstick and comparing the color coded results to the key.

        automated testing (81001 and 81003) is done by inserting the dipstick into a machine to get a printout of the results.

        Of these same 4 codes, one from each method includes microscopy (81000 and 81001) and the other 2 (81002 and 81003) do not include microscopy.

      • Thank you so much! Up until today, I didn’t know what the difference was in those codes. Since my providers use the color coded dipstick, I will have to keep using the 81002 code with the modifier work around, but I am so glad we had this conversation in the comments so that other readers who come can read your explanation and choose the code that most accurately represents what they do in their offices.

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