Can you give me some tips for reflex urinalysis when it comes to compliance?
Urine cultures are sometimes reflexed “when indicated” by abnormal results on the urinalysis. While this is a good medical practice, it can be a sticky situation with compliance. Ensure that physicians have the option to select urinalysis either with or without reflex. Another safe practice is to disclose all reflex test components with your annual physician acknowledgments of custom panels. In order for Medicare coverage to be provided for urinalysis, the patient must have signs or symptoms of a kidney/urinary tract disorder or a condition that is known to affect the kidney/urinary tract. Note that protocols are not accepted by Medicare as orders. The additional diagnosis for coverage of the urine culture must come from the ordering physician and not be assumed by the laboratory based on test results.
This question was answered in our Coding Essentials for Laboratories. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.