tci Part B Insider - 2011 Issue 31

Reader Question: Labs Should Get Reason for Urinalysis

Question: A physician client routinely sends our lab orders for "screening" urinalysis for Medicare patients as part of an annual wellness visit, but we get denials for the test. What is the coverage problem, and how can we resolve it?Answer: Medicare does not pay for a screening urinalysis assay, so that's the coverage problem. Medicare urinalysis coverage depends upon the patient having signs or symptoms supporting medical necessity (such as burning during urination).If you routinely receive screening urinalysis requests as part of the ordering physician's annual wellness visits, ask the physician to obtain a signed at Advance...

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