0 Urinary tract infection, site not specified. Use additional code (B95-B98), if desired, to identify infectious agent.
CMS did note that some “unspecified” codes could still be used. For example, one of the codes they reclassified as “acceptable” — Urinary tract infection, site not specified (N39. 0) — is often the primary diagnosis code.
87086 Culture, bacterial; quantitative, colony count, urine.
2022 ICD-10-CM Diagnosis Code N39. 41: Urge incontinence.
440.
CPT 87088, 87184, and 87186 may be used multiple times in association with or independent of 87086, as urinary tract infections may be polymicrobial. Testing for asymptomatic bacteriuria as part of a prenatal evaluation may be medically appropriate but is considered screening and, therefore, not covered by Medicare.
Other abnormal findings in urine R82. 998 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM R82. 998 became effective on October 1, 2021.
ICD-10 | Hematuria, unspecified (R31. 9)
Medicare also covers clinical laboratory services, including urine drug testing (UDT), under Part B. Physicians use UDT to detect the presence or absence of drugs or to identify specific drugs in urine samples.
ICD-10 | Nocturnal enuresis (N39. 44)
R32: Unspecified urinary incontinence.
ICD-10 | Retention of urine, unspecified (R33. 9)
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All services billed to Medicare must be documented as billed and be medically necessary. CPT codes 81002, 81025, 82270, 82272, 82962, 83026, 84830, 85013, and 85651 do not require a QW modifier to be recognized as a waived test.
CMS (Medicare) has determined that Bacterial Culture, Urine (CPT Codes 87086, 87088) is only medically necessary and, therefore, reimbursable by Medicare when ordered for patients with any of the diagnostic conditions listed below in the “ICD-9-CM Codes Covered by Medicare Program.” If you are ordering this test for a ...
(2) the service must be medically necessary or indicated. Once these two criteria are met, Medicare pays for most clinical laboratory tests based on the Laboratory Fee Schedule.