Friday, 24 February 2017

64455 (anesthetic and steroid) and 64632 (neurolytic agent)

Coverage Guidance

Coverage Indications, Limitations, and/or Medical Necessity

This policy addresses the injection of chemical substances, such as local anesthetics, steroids, sclerosing agents and/or neurolytic agents into ganglion cysts, tendon sheaths, tendon origins/insertions, ligaments, costochondral areas, or near nerves of the feet (e.g., Morton's neuroma) to affect therapy for a pathological condition.

Note: the term "Morton's neuroma" is used in this policy generically to refer to a swollen inflamed nerve in the ball of the foot, including the more specific conditions of Morton's neuroma (lesion within the third intermetatarsal space), Heuter's neuroma (first intermetatarsal space), Hauser's neuroma (second intermetatarsal space) and Iselin's neuroma (fourth intermetatarsal space). This policy applies to each.

Injection of a carpal tunnel is indicated for the patient with a mild case of the carpal tunnel syndrome if oral non-steroidal anti-inflammatory drugs (NSAIDs) and orthoses have failed or are contraindicated. 

Though there are many similarities between Morton’s neuroma and carpal tunnel syndrome, CPT 2009 contains 64455 (anesthetic and/or steroid) and 64632 (neurolytic agent), the specific codes for the Morton‘s neuroma injections. Providers are reminded to use the appropriate one of these codes instead of the previously instructed use of 28899. 

Injection into tendon sheaths, ligaments, tendon origins or insertions, ganglion cysts, or neuromas may be indicated to relieve pain or dysfunction resulting from inflammation or other pathological changes. 

Proper use of this modality with local anesthetics and/or steroids should be short-term, as part of an overall management plan including diagnostic evaluation, in order to clearly identify and properly treat the primary cause. In some circumstances after diagnosis has been confirmed, injection of a sclerosing or neurolytic agent may be appropriate for longer-term management.

The signs or symptoms that justify these treatments should be resolved after one to three injections (see reference 2 below, under "Sources of Information and Basis for Decision"). 

Injections beyond three must be justified by the clinical record indicating a logical reason for failure of the prior therapy and why further treatment can reasonably be expected to succeed. A recurrence may justify a second course of therapy.

Injection therapies for Morton's neuroma do not involve the structures described by CPT code 20550 and 20551 or direct injection into other peripheral nerves but rather the focal injection of tissue surrounding a specific focus of inflammation on the foot. 

These therapies are not to be coded using 20550, 20551, 64450, 64640 or other assigned CPT codes. Rather, the provider of these therapies must bill with CPT code 64455 or 64632 Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) (eg, Morton's neuroma). 

The provider must not bill CPT codes 64450 or 64640 for these injections, since those codes respectively address the additional work of an injection of an anesthetic agent (nerve block), neurolytic or sclerosing agent into relatively more difficult peripheral nerves, rather than that involved in an injection of relatively easily localized areas such as a carpal tunnel or Morton's neuroma.

Injections for plantar fasciitis are addressed by 20550 and ICD-10-CM M72.2. Injections for calcaneal spurs are addressed as are other tendon origin/insertions by 20551. Injections to include both the plantar fascia and the area around a calcaneal spur are to be reported using a single 20551.

Medical necessity for injections of more than two sites at one session or for frequent or repeated injections is questionable. Such injections are likely to result in a request for medical records which must evidence careful justification of necessity.

"Dry needling" of ganglion cysts, ligaments, neuromas, tendon sheaths and their origins/insertions are non-covered procedures. 

Compliance with the provisions in this policy is subject to monitoring by post payment data analysis and subsequent medical review. 

Expand/collapse the Coding Information section Coding Information Bill Type Codes:

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. 

Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.

Revenue Codes:

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the policy, services reported under other Revenue Codes are equally subject to this coverage determination. 

Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.

CPT/HCPCS Codes

Group 1 Paragraph: N/A

Group 1 Codes:

20526 INJECTION, THERAPEUTIC (EG, LOCAL ANESTHETIC, CORTICOSTEROID), CARPAL TUNNEL

20550 INJECTION(S); SINGLE TENDON SHEATH, OR LIGAMENT, APONEUROSIS (EG, PLANTAR "FASCIA")

20551 INJECTION(S); SINGLE TENDON ORIGIN/INSERTION

20612 ASPIRATION AND/OR INJECTION OF GANGLION CYST(S) ANY LOCATION

64455 INJECTION(S), ANESTHETIC AGENT AND/OR STEROID, PLANTAR COMMON DIGITAL NERVE(S) (EG, MORTON'S NEUROMA)

64632 DESTRUCTION BY NEUROLYTIC AGENT; PLANTAR COMMON DIGITAL NERVE

ICD-10 Codes that Support Medical Necessity

Group 1 Paragraph: Note: Diagnosis codes are based on the current ICD-10-CM codes that are effective at the time of LCD publication. Any updates to ICD-10-CM codes will be reviewed by Noridian; and coverage should not be presumed until the results of such review have been published/posted.

These are the only covered ICD-10-CM codes that support medical necessity:

Group 1 Codes:

Show entries for Group 1 ICD-10 Codes that Support Medical Necessity: 

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Group 1Codes

ICD-10 CODE DESCRIPTION

G56.01* Carpal tunnel syndrome, right upper limb
G56.02* Carpal tunnel syndrome, left upper limb
G56.03* Carpal tunnel syndrome, bilateral upper limbs
G57.53* Tarsal tunnel syndrome, bilateral lower limbs
G57.61* Lesion of plantar nerve, right lower limb
G57.62* Lesion of plantar nerve, left lower limb
G57.63* Lesion of plantar nerve, bilateral lower limbs
M24.211 Disorder of ligament, right shoulder
M24.212 Disorder of ligament, left shoulder
M24.221 Disorder of ligament, right elbow
M24.222 Disorder of ligament, left elbow
M24.231 Disorder of ligament, right wrist
M24.232 Disorder of ligament, left wrist
M24.241 Disorder of ligament, right hand
M24.242 Disorder of ligament, left hand
M24.251 Disorder of ligament, right hip
M24.252 Disorder of ligament, left hip
M24.271 Disorder of ligament, right ankle
M24.272 Disorder of ligament, left ankle
M24.274 Disorder of ligament, right foot
M24.275 Disorder of ligament, left foot
M24.28 Disorder of ligament, vertebrae
M25.711 Osteophyte, right shoulder
M25.712 Osteophyte, left shoulder
M25.721 Osteophyte, right elbow
M25.722 Osteophyte, left elbow
M25.731 Osteophyte, right wrist
M25.732 Osteophyte, left wrist
M25.741 Osteophyte, right hand
M25.742 Osteophyte, left hand
M25.751 Osteophyte, right hip
M25.752 Osteophyte, left hip
M25.761 Osteophyte, right knee
M25.762 Osteophyte, left knee
M25.771 Osteophyte, right ankle
M25.772 Osteophyte, left ankle
M25.774 Osteophyte, right foot
M25.775 Osteophyte, left foot
M35.7 Hypermobility syndrome
M45.0 Ankylosing spondylitis of multiple sites in spine
M45.1 Ankylosing spondylitis of occipito-atlanto-axial region
M45.2 Ankylosing spondylitis of cervical region
M45.3 Ankylosing spondylitis of cervicothoracic region
M45.4 Ankylosing spondylitis of thoracic region
M45.5 Ankylosing spondylitis of thoracolumbar region
M45.6 Ankylosing spondylitis lumbar region
M45.7 Ankylosing spondylitis of lumbosacral region
M45.8 Ankylosing spondylitis sacral and sacrococcygeal region
M46.02 Spinal enthesopathy, cervical region
M46.03 Spinal enthesopathy, cervicothoracic region
M46.04 Spinal enthesopathy, thoracic region
M46.05 Spinal enthesopathy, thoracolumbar region
M46.06 Spinal enthesopathy, lumbar region
M46.07 Spinal enthesopathy, lumbosacral region
M46.08 Spinal enthesopathy, sacral and sacrococcygeal region
M46.09 Spinal enthesopathy, multiple sites in spine
M46.82 Other specified inflammatory spondylopathies, cervical region
M46.83 Other specified inflammatory spondylopathies, cervicothoracic region
M46.84 Other specified inflammatory spondylopathies, thoracic region
M46.85 Other specified inflammatory spondylopathies, thoracolumbar region
M46.86 Other specified inflammatory spondylopathies, lumbar region
M46.87 Other specified inflammatory spondylopathies, lumbosacral region
M46.88 Other specified inflammatory spondylopathies, sacral and sacrococcygeal region
M46.89 Other specified inflammatory spondylopathies, multiple sites in spine
M48.8X2 Other specified spondylopathies, cervical region
M48.8X3 Other specified spondylopathies, cervicothoracic region
M48.8X4 Other specified spondylopathies, thoracic region
M48.8X5 Other specified spondylopathies, thoracolumbar region
M48.8X6 Other specified spondylopathies, lumbar region
M48.8X7 Other specified spondylopathies, lumbosacral region
M48.8X8 Other specified spondylopathies, sacral and sacrococcygeal region
M49.82 Spondylopathy in diseases classified elsewhere, cervical region
M49.83 Spondylopathy in diseases classified elsewhere, cervicothoracic region
M49.84 Spondylopathy in diseases classified elsewhere, thoracic region
M49.85 Spondylopathy in diseases classified elsewhere, thoracolumbar region
M49.86 Spondylopathy in diseases classified elsewhere, lumbar region
M49.87 Spondylopathy in diseases classified elsewhere, lumbosacral region
M49.88 Spondylopathy in diseases classified elsewhere, sacral and sacrococcygeal region
M49.89 Spondylopathy in diseases classified elsewhere, multiple sites in spine
M53.2X8 Spinal instabilities, sacral and sacrococcygeal region
M53.3 Sacrococcygeal disorders, not elsewhere classified
M60.811 Other myositis, right shoulder
M60.812 Other myositis, left shoulder
M60.821 Other myositis, right upper arm
M60.822 Other myositis, left upper arm
M60.831 Other myositis, right forearm
M60.832 Other myositis, left forearm
M60.841 Other myositis, right hand
M60.842 Other myositis, left hand
M60.851 Other myositis, right thigh
M60.852 Other myositis, left thigh
M60.861 Other myositis, right lower leg
M60.862 Other myositis, left lower leg
M60.871 Other myositis, right ankle and foot
M60.872 Other myositis, left ankle and foot
M60.88 Other myositis, other site
M60.89 Other myositis, multiple sites
M65.221 Calcific tendinitis, right upper arm
M65.222 Calcific tendinitis, left upper arm
M65.231 Calcific tendinitis, right forearm

Group 1 Medical Necessity ICD-10 Codes Asterisk Explanation: *Use G56.01 and G56.02 for Carpal Tunnel Syndrome. ONLY CPT 20526 may be used with this diagnosis code.

*Use G57.61, G57.62 or G57.63 for Morton's metatarsalgia, neuralgia, or neuroma. NOTE: ONLY CPT 64455 or 64632 may be used with this diagnosis code.

Showing 1 to 100 of 1210 entries in Group 1

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ICD-10 Codes that DO NOT Support Medical Necessity

Group 1 Paragraph: All ICD-10-CM codes not listed in this policy under ICD-10-CM Codes that Support Medical Necessity above.

Group 1 Codes: N/A

Additional ICD-10 Information N/A

Thursday, 23 February 2017

ICD-9-CM , ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Code Sets

Learn about definitions and payment information on these code sets:

• International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)

• International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)

• International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS)

• Current Procedural Terminology (CPT)

• HCPCS

DEFINITIONS AND PAYMENT INFORMATION

This chart provides definitions and payment information for the ICD-9-CM, ICD-10-CM, ICD-10-PCS, CPT, and HCPCS code sets

Code Set : ICD-9-CM 

Definition : 

• The code set all providers, including physicians, used to report medical diagnoses and procedures in U.S. health care settings and hospital inpatient procedures on claims for services furnished through September 30, 2015. 

• Providers selected codes based on documentation in the patient’s medical record. 

• The World Health Organization developed ICD-9. The National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), modified ICD-9 diagnosis codes for use in the U.S. and maintained the ICD-9-CM diagnosis code set (Volumes 1 and 2). The Centers for Medicare & Medicaid Services (CMS) developed and maintained the procedure code set (Volume 3).

Payment Information : 

• When physicians reported ICD-9-CM diagnosis codes on claims, in general, the Medicare Administrative Contractor (MAC) used the codes to determine coverage, not to determine the amount CMS would pay for furnished services.

• When inpatient providers reported ICD-9-CM diagnosis and procedure codes on claims, the MAC used the codes to assign discharges to the appropriate Medicare Severity-Diagnosis Related Group (MS-DRG). 

ICD-10-CM (Diagnoses):

Definition :

The code set that replaces ICD-9-CM to report medical diagnoses on claims for services furnished on or after October 1, 2015.

• All providers, including physicians, use it in U.S. health care settings. 

• Providers select codes based on documentation in the patient’s medical record.

• CDC developed and maintains the code set.

Payment Information : 

• When physicians report diagnosis codes on claims, in general, the MAC will use the codes to determine coverage, not to determine the amount CMS will pay for furnished services.

• Inpatient providers report ICD-10-CM diagnosis and ICD-10-PCS procedure codes on claims, which the MAC will use to assign discharges to the appropriate MS-DRG.

ICD-10-PCS (Procedures): 

Definition :

• The code set providers use to report procedures performed only in U.S. hospital inpatient health care settings on claims furnished on or after October 1, 2015.

• Physicians do not use the code set to report their services, including ambulatory services and inpatient visits.

• Providers select codes based on documentation in the patient’s medical record.

• CMS developed and maintains the code set.

Payment Information :

• Physicians, suppliers, outpatient facilities, and hospital outpatient departments:

o Report and receive payments for furnished services, including physician visits to inpatients, based on CPT and HCPCS codes 

o Use only ICD-10-CM (diagnosis) codes, not ICD-10-PCS (procedure) codes, on claims

• Inpatient providers report ICD-10-CM diagnosis and ICD-10-PCS  procedure codes on claims, which the MAC will use to assign discharges to the appropriate MS-DRG.

HCPCS

Definition :

• Level I codes and modifiers are the CPT codes.

• Level II codes and modifiers primarily identify products, supplies, and services not included in the CPT codes (such as ambulance services; drugs; devices; and durable medical equipment, prosthetics, orthotics, and supplies).

Payment Information :

• When providers report HCPCS codes on claims, the MAC uses the codes to either determine coverage or the amount CMS will pay for furnished services (less beneficiary coinsurance and copayments).

Level I HCPCS: CPT 

Definition: 

• The code set providers use to report medical procedures and professional services furnished in ambulatory/outpatient settings, including physician visits to inpatients.

• The American Medical Association (AMA) developed, copyrighted, and maintains the code set.

Payment Information : 

• When providers report Level I HCPCS CPT codes on claims, the MAC uses the codes to determine the service performed. Claims are paid when the decision is made that Medicare can reimburse for the services (less beneficiary coinsurance and copayments).

• Physicians, suppliers, outpatient facilities, and hospital outpatient departments:

o Report and receive payments for furnished services, including physician visits to inpatients, based on CPT codes

o Use only ICD-10-CM (diagnosis) codes, not ICD-10-PCS (procedure) codes, on claims

o Follow CMS guidance when reporting CPT codes, including CPT modifiers for laterality .

Level II HCPCS: Alphanumeric HCPCS:

Definition : 

• The code set providers use to report medical items, supplies, procedures, and certain professional services that are not described by any CPT codes.

• CMS maintains the code set, with the exception of the code set for dental services (D-codes). The American Dental Association (ADA) developed, copyrighted, and maintains the D-codes.

Payment Information : 

• When providers report Level II HCPCS codes on claims, the MAC uses the codes to either determine coverage or payment for furnished items and services (less beneficiary coinsurance and copayments).

• Physicians, suppliers, outpatient facilities, and hospital outpatient departments:

o Report and receive payments for furnished services, including physician visits to inpatients, based on HCPCS codes

o Use only ICD-10-CM (diagnosis) codes, not ICD-10-PCS (procedure) codes, on claims

o Follow CMS guidance when reporting HCPCS codes, including HCPCS modifiers for laterality.

Saturday, 18 February 2017

Medical Coder's Wages and Pay

Medical coder pay

If you are an entry level medical coder in the United States your pay usually starts at $11 to $13 per hour, an individual with experience of 2-5 years can earn $15-$18 per hour, highly experienced medical coders with specialty certifications can earn as much as $23 per hour, or more. Here is a breakdown of typical factors that can strongly affect the medical coder's take home pay:

Training – Industry specific training and credentials are probably the biggest factors influencing take home pay right along with years of experience.

Experience – Your work experience plays another important role. High recommendations from a former employer who attests to your experience and value to the company speaks louder than anything else in the healthcare industry. This could be your strongest negotiation point when discussing pay.

Company Size & Setting – Large companies may be able to offer higher wages than small businesses. The local job market situation also influences pay rates and the value you bring to the businesses.

Geographic Location – The location of the job can have a big influence on salary. Jobs in a metropolitan area is usually higher compared to small cities and urban areas.

Specialization – A specialty also affects wages. Some medical coders are highly specializes, or consultants in specific areas of the medical and healthcare coding and billing industry. Others are mentors at workshops, professional speakers at seminars, or authors of textbooks and teaching materials.

Self-Employed – Your employment type also affects how much money you can make. While as an employee you are likely on a per hour compensation with incremental wage increases over time, you will set your own rates as a self-employed individual. 

A few years ago AAPC published a detailed article and charts on their website that shows how much medical coders typically earn along with a separate list of salaries by specialty and salaries by title. You can probably still find the article if you use a search engine and query: "AAPC wage study and comparison for medical coders".

As of January 1, 2012, medical billing reimbursement claims must be submitted electronically using the Accredited Standards Committee (ASC) X12 Version 5010, the new version of the X12 standards for Health Insurance Portability and Accountability Act (HIPAA) transactions. 

Implementation of HIPAA Version 5010 will require changes to software, systems and perhaps procedures that you use for billing Medicare and other payers.

Level I compliance means "that a covered entity can demonstrably create and receive compliant transactions, resulting from the compliance of all design/build activities and internal testing." 

Level II compliance means "that a covered entity has completed end-to-end testing with each of its trading partners, and is able to operate in production mode with the new versions of the standards."

HHS permits dual use of existing standards (4010A1 and 5.1) and the new standards (5010 and D.0) from the March 17, 2009, effective date until the January 1, 2012 compliance date to facilitate testing subject to trading partner agreement.

It is extremely important that all medical billing staff and consultants are aware of this HIPAA change and in compliance. 

Tough Decisions: Online Medical Assistant Program or Campus Based?

Online medical assistant student

No one can tell you which type of medical coding and billing training program is right for you. Ultimately, you are the one who must choose which path to take to learn your skills. 

Part of your decision will be based on how FAST you want to be done and finished with your training, tuition cost and how quickly you hope to land your first real medical assistant job.

Rule of thumb is that self-paced online courses can be finished the fastest if you apply yourself, however, on the flip side, doctors may not be easily persuaded or convinced to hire you without having direct experience and hands on practice which you would have gotten in a campus based training program. 

All too many former medical coding and billing online students have learned a painful lesson.

As with any kind of education, there are things to be aware of and different programs have their pros and cons. Making a wise choice and informed decisions puts you into a position where you won't have to regret it later. 

Should you decide that going with a web based program better fits your schedule, budget and personality than bear in mind that no matter which online school you choose you have to ask certain questions BEFORE signing up for anything. 

First and foremost check out the fees that the online nursing charges for their courses and find out their refund policy. It is common practice of all reputable online vocational training schools to be up-front with their fees, since they realize it is important to new students to know how much they will be paying for the course. 

Putting forth a sincere effort to discuss all fees person-to-person over the phone helps to build trust in the school.

You will need to check out the course requirements before signing up for anything.  Each school has different requirements that must be met before entering their program. 

Almost all online self-study programs to become a medical coder and biller require a high school diploma while a few want you to have specific course studies from other schools. 

Some online medical assistant programs, especially those approved by the Department of Education, require competency in complex clinical and technical skills to earn their degree, which can only taught under the direct supervision of a qualified instructor or professional in the field who is familiar with a wide range of medical assistant duties.

There are countless medical coding and billing students who have told us that finding  their own clinical internship site was EXTREMELY challenging and frustrating and some of them gave up, never earning their medical assistant diploma or degree. 

Therefore this is probably the most important part of evaluating a prospective online medical assistant school. 

Certain online programs operate on the same premise of standard schools and might require that their students complete a minimum number of hours in class room study to be eligible to graduate; so, make sure to ask whether a program is entirely web based, or partially web based. 

All that is required should be listed in the course description and should be discussed in person during the review process.

Academic degrees is another area where one should put fourth some effort in research before signing up for anything. If the online program does not offer the degree that you need to get the job you want, then it is useless to you as a school. 

Don't be discouraged, most of the online medical coding and billing schools, and allied health vocational colleges for that matter, allow you to achieve the type of degree that you want.

Worth Your Consideration When Making Career Choices: Phlebotomist

The phlebotomist, the person who draws blood samples from patients arms or finger tips, is a highly specialized, valuable member of the medical and healthcare team as a whole. Without the phlebotomist's skills and services many diagnoses and health assessments could not be as reliably performed.

 Most phlebotomists have a high school education, others have an academic degree in medical technology, some received their training directly on the job under the supervision of a doctor, nurse or experienced phlebotomist, others took a phlebotomy course offered through the American Red Cross, or a community college, others while serving in the military as a combat medic or hospital corpsman role.

A skilled phlebotomist deserves high praise, yet, they are usually paid the least amount of wages on the allied health professional's pay scale, probably because their training is not as extensive as, let's say, an EKG and x-ray technician, or medical assistant. In a way, that is unfair, because there is tremendous value in their services that can never be repaid in money. 

Phlebotomists draw blood for tests, transfusions, donations, or research and explain the procedure to patients who ask.

They must know the circulatory system anatomy and composition of blood along with the medical terminology that goes with it, be able to access a vein, or artery, or capillary blood bed of all kinds of people from young, to old, to obese, to emaciated, to those with veins that roll, to those who easily faint, or are deadly afraid of needles.

They need to understand different venipuncture techniques and the equipment to be used to draw and preserve the blood sample. Additionally, they must know how to read laboratory requisition slips, follow doctor's orders, work safely with patients, handle blood and other potentially hazardous body fluids and know how to clean up blood spills safely and dispose them in accordance with OSHA regulations. 

If any of this is not approached with great care and handled properly, it can result in severe injury, if not death.

Friday, 17 February 2017

How to Choose the Right Vocational Training Program for Medical Billing

Being a smart consumer pays off when choosing vocational training programs especially online. Warning signs and program quality check points do exist...  and there are many excellent educational and vocational training programs offered on the Internet. 

It is the dubious providers of distance and online education that crank out certificates and degrees that are considered worthless on the job market. 

If you obtain a degree or take a course from a shady non-accredited cyber-school you may find that the paper you receive stamped "Certificate" is not recognized by potential employers, and that the course credits may not transfer to other schools. This is where the term "diploma mill' comes to mind.

Diploma Mills Can Make The Unthinkable Real

It simply blows the mind: doctors, clergymen, police officers, teachers, federal employees, such as White House staffers, National Security Agency employees, FBI agents and a senior State Department officials purchased bogus degrees to seek employment, promotions, higher positions and better pay. 

Nowadays, almost anybody can become a doctor, or receive college level and advanced degrees, with almost zero effort. Even medical assistants can find gray area online medical assistant programs without any special pre-enrollment conditions, qualification screenings, or passing grade standards... for just a few hundred dollars. 

Make The Doctor See that YOU are the Best Candidate for The Job

Qualified_medical_assistant 

Medical assistant, phlebotomy and laboratory technician, medical billing and coding certifications are reaching a new level of recognition with employers. 

While taking an allied health professional certification exam remains largely voluntary here in the USA, there is definitely a big trend among employers who specifically stipulate in their job ads that a medical office position which needs to be filled requires certified credentials.

Rarely do you see medical assistants being hired without experience and trained directly on the job anymore. Doctors expect more these days. 

These doctors and medical facilities clearly see the benefits of hiring someone with certified credentials; they want someone who has the knowledge necessary to work side by side with health and medical staff to run their medical office or health care facility efficiently and safely. 

Hiring competent and well trained medical assisting staff gives them a certain amount of confidence and assurance.

An example of such a job advertisement is this one randomly picked from the Indeed.com jobs bank today:

XYZ Physician Associates, LLC currently has a full time medical assistant position available working in a very fast paced environment. Requirements: 

Candidates must have six months to one year related experience in a medical office or similar clinical setting. Candidates must also be highly organized, pay attention to detail and be able to multi-task. Computer skills required. 

Phlebotomy experience preferred. Graduate of a Medical Assisting Program. Certification preferred.

Medical assistant training institutions and community colleges know this and are heeding the call by offering medical assistant training programs that lead to desired diplomas and qualifies their graduates to sit for recognized medical assistant certification exams. 

Funding and financial assistance for such training programs is readily available for those who qualify, much of it completely free and must never be paid back if you are, for example, presently unemployed and qualify for educational grants and employment rehab programs.


There are a number of different medical assistant and other allied health occupations certification sponsors, each having their own unique certification requirements.

Their certification exams serve as a valid means of assessing an individual’s specific knowledge and competence in the medical assistant occupation. 

Passing any one of the various offered certification exams adds credibility and credentials to your name by having earned recognized designations in a specific discipline. 

Once you have earned your credentials they are portable to all places you may work now and in the future. This is important because in today’s economy people may have to move to a different location or across boarders to a different state to go where the jobs, or better jobs are.

CPT 81001

81003 - Urinalysis, automated without microscopy

Lab Dept: Urine/Stool

Test Name: URINALYSIS (UA)

General Information

Lab Order Codes: UA

Synonyms: Urinalysis, Routine

CPT Codes: 81001 - Urinalysis, automated with microscopy

Test Includes: Bilirubin, blood, clarity, color, glucose, ketones, leukocyte esterase, nitrite, pH, protein, specific gravity, and urobilinogen

Logistics

Test Indications: Useful as a screen for abnormalities of urine; diagnosing and managing renal diseases, urinary tract infections, urinary tract neoplasms, systemic diseases, inflammatory or neoplastic diseases adjacent to the urinary tract
and dehydration. 

Lab Testing Sections: Urinalysis

Phone Numbers: MIN Lab: 612-813-6280

STP Lab: 651-220-6550

Test Availability: Daily, 24 hours

Turnaround Time: 2 hours

Special Instructions: Send to lab within 30 minutes of collection.

CPT/HCPCS Codes GroupName

81000 URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; NON-AUTOMATED, WITH MICROSCOPY

81001 URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; AUTOMATED, WITH MICROSCOPY

81002 URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; NON-AUTOMATED, WITHOUT MICROSCOPY

81003 URINALYSIS, BY DIP STICK OR TABLET REAGENT FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONES, LEUKOCYTES, NITRITE, PH, PROTEIN, SPECIFIC GRAVITY, UROBILINOGEN, ANY NUMBER OF THESE CONSTITUENTS; AUTOMATED, WITHOUT MICROSCOPY

81005 URINALYSIS; QUALITATIVE OR SEMIQUANTITATIVE, EXCEPT IMMUNOASSAYS

11/21/2010 - For the following CPT/HCPCS codes either the short description and/or the long description was changed. Depending on which description is used in this LCD, there may not be any change in how the code displays in the document:

81000 descriptor was changed in Group 1

81001 descriptor was changed in Group 1

81003 descriptor was changed in Group 1

81020 descriptor was changed in Group 1

URINALAYSIS

CPT CODES: 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific  gravity, urobilinogen, any number of these constituents;  non-automated, with microscopy

 81001 automated, with microscopy

 81002 non-automated, without microscopy

 81003 automated, without microscopy

81005 Urinalysis, qualitative or semi-quantitative, except immunoassays

81007 Urinalysis, bacteriuria screen, by non-culture, commercial kit

 81015 Urinalysis, microscopic only

 81025 Urine pregnancy test, by visualcolor comparison methods

 81050 Volume measurement for timed collection, each 

Correspondence Language Policy/Example Number 4.80000 - Mutually exclusive procedures

For example, CPT codes 81000 and 81001 describe different ways of performing urinalysis with microscopy. The procedure described by CPT code 81000 utilizes a manual process with dip stick or tablet reagent, and the procedure described by CPT code 81001 utilizes an automated process. 

Since both procedures would not be performed on the same urine specimen at the same patient encounter, the two procedures are mutually exclusive of one another.

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