All PlansBilling CodesMedium impact
Newsletter Vol. 4, No. 29
New Jersey Medicaid·NJ · Family Medicine, Internal Medicine, General Practice·Coding
We identified it
Jun 20, 2026
Summary
Laboratories with Physician-Performed Microscopy Procedures (PPMP) certificates are experiencing billing problems when using CPT code 81000 for urinalysis. This policy addresses specific billing issues and likely provides guidance on proper coding or billing procedures for these laboratory services.
Action Required
Immediately: Billing team should review the full policy document at https://www.njmmis.com/documentDownload.aspx?document=4-29.pdf to understand the specific billing problems with CPT 81000 for PPMP-certified laboratories. Update billing procedures and system edits as outlined in the complete policy to prevent claim denials or billing errors.