Is CPT 87086 covered by Medicare?
Table of Contents
CMS (Medicare) has determined that Bacterial Culture, Urine (CPT Codes 87086, 87088) is only medically necessary and, therefore, reimbursable by Medicare when ordered for patients with any of the diagnostic conditions listed below in the “ICD-9-CM Codes Covered by Medicare Program.” If you are ordering this test for a …
What ICD 10 codes cover urinalysis?

81007 Urinalysis; bacteriuria screen, except by culture or dipstick.
What ICD 10 codes cover urine culture?
Unspecified abnormal findings in urine
- microbiological examination R82.79 (culture)
- positive culture R82.79.
Does Medicare pay for urinalysis?
Urinalysis is one of the laboratory services covered under Part B. Medicare benefits also include blood tests, screening tests and some tissue specimen testing. To be covered, the test must be medically necessary, ordered by a qualified health care practitioner and performed by a Medicare-approved laboratory.

What does routine urine culture test for?
A urine culture test can identify bacteria or yeast causing a urinary tract infection (UTI). If bacteria multiply, an antibiotic sensitivity test can identify the antibiotic most likely to kill those particular bacteria. Your healthcare provider may order a urine culture if you get chronic or hard-to-treat UTIs.
What is a routine urine culture?
A routine urine culture detects the amount of germs (microorganisms like bacteria) present in the urine. Once a urine sample is collected, a technician will keep it in conditions where microorganisms can multiply. Normally, no more than a small number of germs will be in the urine if there’s no infection.
Why does Medicare not pay for urinalysis?
Urine screenings for employment and other non-medical reasons would not be eligible for coverage under Medicare benefits. With Medicare Part B coverage, most medically necessary diagnostic tests do not require copays or coinsurances. Part A benefits cover diagnostic tests for inpatient hospital stays.