PROVIDER INELIGIBLE TO FILE CPT 81001 - Denial reason

DESCRIPTION OF THE ISSUE
We received denials for the CPT 81001 as “Provider is not certified eligible to perform this procedure” - CPT 81001 (Urinalysis with microscope)

CONCEPT
Any provider should be aware of his eligibility of the services to be performed for appropriate reimbursements.

SOLUTION
Per Coding Dept’s advice we changed CPT from 81001 to 81002 (Urinalysis without microscopy) and refiled all the denied claims for reprocessing.  The refiled claims were paid successfully.

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