Urine Culture, Bacterial CPT Code: Medicare National Coverage Determination Policy

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1 Urine Culture, Bacterial CPT Code: Medicare National Coverage Determination Policy ICD10 R R82.8 R82.7 R82.6 N75.1 N45.4 N41.2 N76.4 R82.4 E87.2 A42.7 R10.0 K72.01 K72.00 N30.01 N30.00 N71.0 N17.1 N17.2 N00.4 N00.3 N00.1 N00.7 N00.2 N00.5 N00.6 N00.0 N00.8 N00.9 N70.02 N73.0 N41.0 J80 DESCRIPTION Abdominal tenderness, unspecified site Abnormal findings on cytolog and histolog exam of urine Abnormal findings on microbiological examination of urine Abnormal urine levels of substances chiefly nonmed source Abscess of Bartholin's gland Abscess of epididymis or testis Abscess of prostate Abscess of vulva Acetonuria Acidosis Actinomycotic sepsis Acute abdomen Acute and subacute hepatic failure with coma Acute and subacute hepatic failure without coma Acute cystitis with hematuria Acute cystitis without hematuria Acute inflammatory disease of uterus Acute kidney failure with acute cortical necrosis Acute kidney failure with medullary necrosis Acute neph syndrome w diffuse endocaplry prolif glomrlneph Acute neph syndrome w diffuse mesangial prolif glomrlneph Acute neph syndrome w focal and segmental glomerular lesions Acute nephritic syndrome w diffuse crescentic glomrlneph Acute nephritic syndrome w diffuse membranous glomrlneph Acute nephritic syndrome w diffuse mesangiocap glomrlneph Acute nephritic syndrome with dense deposit disease Acute nephritic syndrome with minor glomerular abnormality Acute nephritic syndrome with other morphologic changes Acute nephritic syndrome with unsp morphologic changes Acute oophoritis Acute parametritis and pelvic cellulitis Acute prostatitis Acute respiratory distress syndrome

2 N70.01 N70.03 N10 N76.0 N76.2 D70.1 R41.82 N14.0 N53.13 R45.84 R41.1 R34 Z93.52 N50.0 R78.81 P36.9 N15.0 R80.3 N44.2 R31.1 R82.2 N21.0 N21.1 N20.0 N20.2 N21.9 N42.0 N20.1 N22 R57.0 K76.2 O86.11 R68.83 A56.01 A56.11 A56.02 N71.1 N11.1 N70.12 N73.1 N41.1 N70.11 Acute salpingitis Acute salpingitis and oophoritis Acute tubulo-interstitial nephritis Acute vaginitis Acute vulvitis Agranulocytosis secondary to cancer chemotherapy Altered mental status, unspecified Analgesic nephropathy Anejaculatory orgasm Anhedonia Anterograde amnesia Anuria and oliguria Appendico-vesicostomy status Atrophy of testis Bacteremia Bacterial sepsis of newborn, unspecified Balkan nephropathy Bence Jones proteinuria Benign cyst of testis Benign essential microscopic hematuria Biliuria Calculus in bladder Calculus in urethra Calculus of kidney Calculus of kidney with calculus of ureter Calculus of lower urinary tract, unspecified Calculus of prostate Calculus of ureter Calculus of urinary tract in diseases classified elsewhere Cardiogenic shock Central hemorrhagic necrosis of liver Cervicitis following delivery Chills (without fever) Chlamydial cystitis and urethritis Chlamydial female pelvic inflammatory disease Chlamydial vulvovaginitis Chronic inflammatory disease of uterus Chronic obstructive pyelonephritis Chronic oophoritis Chronic parametritis and pelvic cellulitis Chronic prostatitis Chronic salpingitis

3 N70.13 N11.9 R82.0 R10.83 D70.0 N42.1 N39.45 N13.5 Z93.51 D70.4 N75.0 N50.3 N28.1 N42.83 N44.1 N30.91 N30.90 N75.9 N28.9 N50.9 N42.9 N51 R41.0 D65 M54.9 R50.2 R33.0 E09.21 E09.22 E09.29 N42.3 R30.0 R68.81 R82.5 Z43.5 Z43.6 N18.6 O86.12 N40.1 N40.0 N45.1 N45.3 Chronic salpingitis and oophoritis Chronic tubulo-interstitial nephritis, unspecified Chyluria Colic Congenital agranulocytosis Congestion and hemorrhage of prostate Continuous leakage Crossing vessel and stricture of ureter w/o hydronephrosis Cutaneous-vesicostomy status Cyclic neutropenia Cyst of Bartholin's gland Cyst of epididymis Cyst of kidney, acquired Cyst of prostate Cyst of tunica albuginea testis Cystitis, unspecified with hematuria Cystitis, unspecified without hematuria Disease of Bartholin's gland, unspecified Disorder of kidney and ureter, unspecified Disorder of male genital organs, unspecified Disorder of prostate, unspecified Disorders of male genital organs in diseases classd elswhr Disorientation, unspecified Disseminated intravascular coagulation Dorsalgia, unspecified Drug induced fever Drug induced retention of urine Drug/chem diabetes mellitus w diabetic nephropathy Drug/chem diabetes w diabetic chronic kidney disease Drug/chem diabetes w oth diabetic kidney complication Dysplasia of prostate Dysuria Early satiety Elevated urine levels of drug/meds/biol subst Encounter for attention to cystostomy Encounter for attn to oth artif openings of urinary tract End stage renal disease Endometritis following delivery Enlarged prostate with lower urinary tract symptoms Enlarged prostate without lower urinary tract symptoms Epididymitis Epididymo-orchitis

4 R R10.13 R R39.2 N44.01 R39.0 R50.84 R39.14 N73.3 N73.4 N82.9 N82.5 N74 N73.9 N73.6 N73.5 R50.81 R50.9 N82.3 N82.2 T19.1XXA T19.4XXA T19.0XXA N49.3 R35.0 R39.81 R10.84 R R O08.0 M32.14 N08 R81 A41.50 N41.4 R31.0 R36.1 R31.9 R82.3 N07.4 N07.3 N07.1 Epigastric abdominal tenderness Epigastric pain Epigastric rebound abdominal tenderness Extrarenal uremia Extravaginal torsion of spermatic cord Extravasation of urine Febrile nonhemolytic transfusion reaction Feeling of incomplete bladder emptying Female acute pelvic peritonitis Female chronic pelvic peritonitis Female genital tract fistula, unspecified Female genital tract-skin fistulae Female pelvic inflam disorders in diseases classd elswhr Female pelvic inflammatory disease, unspecified Female pelvic peritoneal adhesions (postinfective) Female pelvic peritonitis, unspecified Fever presenting with conditions classified elsewhere Fever, unspecified Fistula of vagina to large intestine Fistula of vagina to small intestine Foreign body in bladder, initial encounter Foreign body in penis, initial encounter Foreign body in urethra, initial encounter Fournier gangrene Frequency of micturition Functional urinary incontinence Generalized abdominal pain Generalized abdominal tenderness Generalized rebound abdominal tenderness Genitl trct and pelvic infct fol ectopic and molar pregnancy Glomerular disease in systemic lupus erythematosus Glomerular disorders in diseases classified elsewhere Glycosuria Gram-negative sepsis, unspecified Granulomatous prostatitis Gross hematuria Hematospermia Hematuria, unspecified Hemoglobinuria Heredit neuropath, NEC w diffus endocaplry prolif glomrlneph Heredit neuropath, NEC w diffuse mesangial prolif glomrlneph Heredit neuropath, NEC w focal and seg glomerular lesions

5 N07.6 N07.7 N07.2 N07.5 N07.0 N07.8 N07.9 R39.11 N13.4 N28.81 R68.0 R57.1 N39.42 O23.31 O23.32 O23.33 O86.22 O86.21 O O O O O23.11 O23.12 O23.13 O23.10 O O O O O23.01 O23.02 O23.03 O23.00 O23.30 O23.21 O23.22 O23.23 O23.20 N49.1 N72 N41.9 Hereditary nephropathy, NEC w dense deposit disease Hereditary nephropathy, NEC w diffuse crescentic glomrlneph Hereditary nephropathy, NEC w diffuse membranous glomrlneph Hereditary nephropathy, NEC w diffuse mesangiocap glomrlneph Hereditary nephropathy, NEC w minor glomerular abnormality Hereditary nephropathy, NEC w oth morphologic lesions Hereditary nephropathy, NEC w unsp morphologic lesions Hesitancy of micturition Hydroureter Hypertrophy of kidney Hypothermia, not associated w low environmental temperature Hypovolemic shock Incontinence without sensory awareness Infect of prt urinary tract in pregnancy, first trimester Infect of prt urinary tract in pregnancy, second trimester Infect of prt urinary tract in pregnancy, third trimester Infection of bladder following delivery Infection of kidney following delivery Infection oth prt genital tract in pregnancy, unsp trimester Infection oth prt genitl trct in pregnancy, first trimester Infection oth prt genitl trct in pregnancy, second trimester Infection oth prt genitl trct in pregnancy, third trimester Infections of bladder in pregnancy, first trimester Infections of bladder in pregnancy, second trimester Infections of bladder in pregnancy, third trimester Infections of bladder in pregnancy, unspecified trimester Infections of cervix in pregnancy, first trimester Infections of cervix in pregnancy, second trimester Infections of cervix in pregnancy, third trimester Infections of cervix in pregnancy, unspecified trimester Infections of kidney in pregnancy, first trimester Infections of kidney in pregnancy, second trimester Infections of kidney in pregnancy, third trimester Infections of kidney in pregnancy, unspecified trimester Infections of prt urinary tract in pregnancy, unsp trimester Infections of urethra in pregnancy, first trimester Infections of urethra in pregnancy, second trimester Infections of urethra in pregnancy, third trimester Infections of urethra in pregnancy, unspecified trimester Inflam disorders of sperm cord, tunica vaginalis and vas def Inflammatory disease of cervix uteri Inflammatory disease of prostate, unspecified

6 N71.9 N49.9 N49.8 N49.2 N49.0 N30.11 N30.10 N44.02 N30.41 N30.40 N28.0 N06.1 R80.0 N06.7 N06.4 N06.2 N06.3 N06.5 N06.6 N06.0 N06.8 N06.9 R R10.32 R R R10.12 R Z79.3 Z R10.30 N28.82 E87.4 N39.46 N76.81 R82.1 P39.3 R53.0 N14.3 N14.1 N28.83 N14.2 Inflammatory disease of uterus, unspecified Inflammatory disorder of unspecified male genital organ Inflammatory disorders of oth male genital organs Inflammatory disorders of scrotum Inflammatory disorders of seminal vesicle Interstitial cystitis (chronic) with hematuria Interstitial cystitis (chronic) without hematuria Intravaginal torsion of spermatic cord Irradiation cystitis with hematuria Irradiation cystitis without hematuria Ischemia and infarction of kidney Isolated protein w focal and segmental glomerular lesions Isolated proteinuria Isolated proteinuria w diffuse crescentic glomerulonephritis Isolated proteinuria w diffuse endocaplry prolif glomrlneph Isolated proteinuria w diffuse membranous glomerulonephritis Isolated proteinuria w diffuse mesangial prolif glomrlneph Isolated proteinuria w diffuse mesangiocapillary glomrlneph Isolated proteinuria with dense deposit disease Isolated proteinuria with minor glomerular abnormality Isolated proteinuria with other morphologic lesion Isolated proteinuria with unspecified morphologic lesion Left lower quadrant abdominal tenderness Left lower quadrant pain Left lower quadrant rebound abdominal tenderness Left upper quadrant abdominal tenderness Left upper quadrant pain Left upper quadrant rebound abdominal tenderness Long term (current) use of hormonal contraceptives Long term (current) use of opiate analgesic Lower abdominal pain, unspecified Megaloureter Mixed disorder of acid-base balance Mixed incontinence Mucositis (ulcerative) of vagina and vulva Myoglobinuria Neonatal urinary tract infection Neoplastic (malignant) related fatigue Nephropathy induced by heavy metals Nephropathy induced by oth drug/meds/biol subst Nephroptosis Neuropath induced by unsp drug, medicament or biolg sub

7 D70.3 D70.9 R35.1 N39.44 N40.3 N40.2 N11.0 N34.1 A34 N13.9 N70.92 N45.2 R80.2 N29 R82.99 R41.3 Z93.6 P36.8 R82.91 N30.21 N30.20 N11.8 N30.81 N30.80 Z93.59 R39.19 N75.8 M54.89 D70.2 N53.19 R53.83 N82.8 N82.4 N82.1 R68.89 A41.59 O86.19 N41.8 Z N21.8 R53.81 N53.8 Neutropenia due to infection Neutropenia, unspecified Nocturia Nocturnal enuresis Nodular prostate with lower urinary tract symptoms Nodular prostate without lower urinary tract symptoms Nonobstructive reflux-associated chronic pyelonephritis Nonspecific urethritis Obstetrical tetanus Obstructive and reflux uropathy, unspecified Oophoritis, unspecified Orchitis Orthostatic proteinuria, unspecified Oth disorders of kidney and ureter in diseases classd elswhr Other abnormal findings in urine Other amnesia Other artificial openings of urinary tract status Other bacterial sepsis of newborn Other chromoabnormalities of urine Other chronic cystitis with hematuria Other chronic cystitis without hematuria Other chronic tubulo-interstitial nephritis Other cystitis with hematuria Other cystitis without hematuria Other cystostomy status Other difficulties with micturition Other diseases of Bartholin's gland Other dorsalgia Other drug-induced agranulocytosis Other ejaculatory dysfunction Other fatigue Other female genital tract fistulae Other female intestinal-genital tract fistulae Other female urinary-genital tract fistulae Other general symptoms and signs Other Gram-negative sepsis Other infection of genital tract following delivery Other inflammatory diseases of prostate Other long term (current) drug therapy Other lower urinary tract calculus Other malaise Other male sexual dysfunction

8 R31.2 D70.8 N44.8 N13.8 R35.8 R80.8 R33.8 R57.8 F45.8 N28.89 N50.8 N42.89 D72.89 N73.8 N76.89 O86.89 N15.8 A41.89 N A40.8 R39.89 N34.2 O86.29 N R52 N53.12 R30.9 R10.2 R R R10.33 R80.1 R39.12 N N N N35.12 N N R50.82 R50.83 G93.3 Other microscopic hematuria Other neutropenia Other noninflammatory disorders of the testis Other obstructive and reflux uropathy Other polyuria Other proteinuria Other retention of urine Other shock Other somatoform disorders Other specified disorders of kidney and ureter Other specified disorders of male genital organs Other specified disorders of prostate Other specified disorders of white blood cells Other specified female pelvic inflammatory diseases Other specified inflammation of vagina and vulva Other specified puerperal infections Other specified renal tubulo-interstitial diseases Other specified sepsis Other specified urinary incontinence Other streptococcal sepsis Other symptoms and signs involving the genitourinary system Other urethritis Other urinary tract infection following delivery Overflow incontinence Pain, unspecified Painful ejaculation Painful micturition, unspecified Pelvic and perineal pain Periumbilic abdominal tenderness Periumbilic rebound abdominal tenderness Periumbilical pain Persistent proteinuria, unspecified Poor urinary stream Postinfective anterior urethral stricture, NEC Postinfective bulbous urethral stricture, NEC Postinfective membranous urethral stricture, NEC Postinfective urethral stricture, NEC, female Postinfective urethral stricture, NEC, male, meatal Postinfective urethral stricture, NEC, male, unsp Postprocedural fever Postvaccination fever Postviral fatigue syndrome

9 N39.43 N41.3 N42.81 N42.82 R80.9 O85 O86.81 N28.84 N28.85 N13.6 O86.4 N01.4 N01.3 N01.1 N01.7 N01.2 N01.5 N01.6 N01.0 N01.8 N01.9 R N15.1 N15.9 N16 N53.11 R33.9 R41.2 N53.14 R R10.31 R R R10.11 R A02.1 N70.93 N70.91 O O O O Post-void dribbling Prostatocystitis Prostatodynia syndrome Prostatosis syndrome Proteinuria, unspecified Puerperal sepsis Puerperal septic thrombophlebitis Pyelitis cystica Pyeloureteritis cystica Pyonephrosis Pyrexia of unknown origin following delivery Rapid progr neph synd w diffus endocaplry prolif glomrlneph Rapidly progr neph synd w diffus mesangial prolif glomrlneph Rapidly progr neph synd w focal and seg glomerular lesions Rapidly progr neph syndrome w diffuse crescentic glomrlneph Rapidly progr neph syndrome w diffuse membranous glomrlneph Rapidly progr neph syndrome w diffuse mesangiocap glomrlneph Rapidly progr nephritic syndrome w dense deposit disease Rapidly progr nephritic syndrome w minor glomerular abnlt Rapidly progr nephritic syndrome w oth morphologic changes Rapidly progr nephritic syndrome w unsp morphologic changes Rebound abdominal tenderness, unspecified site Renal and perinephric abscess Renal tubulo-interstitial disease, unspecified Renal tubulo-interstitial disord in diseases classd elswhr Retarded ejaculation Retention of urine, unspecified Retrograde amnesia Retrograde ejaculation Right lower quadrant abdominal tenderness Right lower quadrant pain Right lower quadrant rebound abdominal tenderness Right upper quadrant abdominal tenderness Right upper quadrant pain Right upper quadrant rebound abdominal tenderness Salmonella sepsis Salpingitis and oophoritis, unspecified Salpingitis, unspecified Salpingo-oophoritis in pregnancy, first trimester Salpingo-oophoritis in pregnancy, second trimester Salpingo-oophoritis in pregnancy, third trimester Salpingo-oophoritis in pregnancy, unspecified trimester

10 A41.4 A41.81 A41.51 A41.3 A41.02 A41.01 A41.1 A41.52 A41.53 A40.3 A40.0 A40.1 A41.2 O08.82 P36.5 P36.4 P36.39 P36.19 P36.2 P36.0 P36.30 P36.10 A41.9 R65.21 O08.3 R57.9 M35.04 N43.42 N43.41 N43.40 R39.13 R39.16 A40.9 N39.3 N76.1 N76.3 R00.0 N44.04 N44.03 N44.00 N14.4 R40.4 Sepsis due to anaerobes Sepsis due to Enterococcus Sepsis due to Escherichia coli [E. coli] Sepsis due to Hemophilus influenzae Sepsis due to Methicillin resistant Staphylococcus aureus Sepsis due to Methicillin susceptible Staphylococcus aureus Sepsis due to other specified staphylococcus Sepsis due to Pseudomonas Sepsis due to Serratia Sepsis due to Streptococcus pneumoniae Sepsis due to streptococcus, group A Sepsis due to streptococcus, group B Sepsis due to unspecified staphylococcus Sepsis following ectopic and molar pregnancy Sepsis of newborn due to anaerobes Sepsis of newborn due to Escherichia coli Sepsis of newborn due to other staphylococci Sepsis of newborn due to other streptococci Sepsis of newborn due to Staphylococcus aureus Sepsis of newborn due to streptococcus, group B Sepsis of newborn due to unspecified staphylococci Sepsis of newborn due to unspecified streptococci Sepsis, unspecified organism Severe sepsis with septic shock Shock following ectopic and molar pregnancy Shock, unspecified Sicca syndrome with tubulo-interstitial nephropathy Spermatocele of epididymis, multiple Spermatocele of epididymis, single Spermatocele of epididymis, unspecified Splitting of urinary stream Straining to void Streptococcal sepsis, unspecified Stress incontinence (female) (male) Subacute and chronic vaginitis Subacute and chronic vulvitis Tachycardia, unspecified Torsion of appendix epididymis Torsion of appendix testis Torsion of testis, unspecified Toxic nephropathy, not elsewhere classified Transient alteration of awareness

11 N30.31 N30.30 A18.14 N12 M32.15 N76.5 N76.6 N77.0 O23.91 O23.92 O23.93 O23.90 O23.41 O23.42 O23.43 O23.40 N05.4 N05.3 N05.1 N05.7 N05.2 N05.5 N05.0 N05.8 N05.9 R39.9 R41.9 R10.9 R82.90 Z93.50 N53.9 N05.6 N73.2 N23 R32 R10.10 N28.86 N34.0 R36.0 R36.9 N37 N34.3 Trigonitis with hematuria Trigonitis without hematuria Tuberculosis of prostate Tubulo-interstitial nephritis, not spcf as acute or chronic Tubulo-interstitial neuropath in sys lupus erythematosus Ulceration of vagina Ulceration of vulva Ulceration of vulva in diseases classified elsewhere Unsp GU tract infection in pregnancy, first trimester Unsp GU tract infection in pregnancy, second trimester Unsp GU tract infection in pregnancy, third trimester Unsp GU tract infection in pregnancy, unsp trimester Unsp infct of urinary tract in pregnancy, first trimester Unsp infct of urinary tract in pregnancy, second trimester Unsp infct of urinary tract in pregnancy, third trimester Unsp infection of urinary tract in pregnancy, unsp trimester Unsp neph syndrome w diffuse endocaplry prolif glomrlneph Unsp neph syndrome w diffuse mesangial prolif glomrlneph Unsp neph syndrome w focal and segmental glomerular lesions Unsp nephritic syndrome w diffuse crescentic glomrlneph Unsp nephritic syndrome w diffuse membranous glomrlneph Unsp nephritic syndrome w diffuse mesangiocap glomrlneph Unsp nephritic syndrome with minor glomerular abnormality Unsp nephritic syndrome with other morphologic changes Unsp nephritic syndrome with unspecified morphologic changes Unsp symptoms and signs involving the genitourinary system Unsp symptoms and signs w cognitive functions and awareness Unspecified abdominal pain Unspecified abnormal findings in urine Unspecified cystostomy status Unspecified male sexual dysfunction Unspecified nephritic syndrome with dense deposit disease Unspecified parametritis and pelvic cellulitis Unspecified renal colic Unspecified urinary incontinence Upper abdominal pain, unspecified Ureteritis cystica Urethral abscess Urethral discharge without blood Urethral discharge, unspecified Urethral disorders in diseases classified elsewhere Urethral syndrome, unspecified

12 N39.41 R39.15 N20.9 O86.20 N39.0 O86.13 N77.1 N50.1 R30.1 N13.71 N13.70 N N N N N N N82.0 R53.1 Urge incontinence Urgency of urination Urinary calculus, unspecified Urinary tract infection following delivery, unspecified Urinary tract infection, site not specified Vaginitis following delivery Vaginitis, vulvitis and vulvovaginitis in dis classd elswhr Vascular disorders of male genital organs Vesical tenesmus Vesicoureteral-reflux without reflux nephropathy Vesicoureteral-reflux, unspecified Vesicoureter-reflux w reflux nephropathy w hydroureter, unsp Vesicoureter-reflux w reflux nephropathy w/o hydrourt, unsp Vesicoureter-reflux w reflux neuropath w hydrourt, bilateral Vesicoureter-reflux w reflux neuropath w hydrourt, unil Vesicoureter-reflux w reflux neuropath w/o hydrourt, bi Vesicoureter-reflux w reflux neuropath w/o hydrourt, unil Vesicovaginal fistula Weakness