MedicaidCoverageLow impact
Attention Provider Types 12 (Hospital, Outpatient), 43 (Laboratory, Pathology Clinical), and 96 (Rural Emergency Hospital): Laboratory Procedure Code 81513 Open for Billing
Nevada Medicaid·NV · Pathology, OB-GYN·Billing & Coding
Effective date
Mar 18, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has opened laboratory procedure code 81513 (bacterial vaginosis RNA testing) for billing by hospitals, laboratories, and rural emergency hospitals effective March 18, 2025. Claims previously denied for this code will be automatically reprocessed for dates of service from March 18 through November 17, 2025.
Action Required
No immediate action required: Nevada Medicaid will automatically reprocess previously denied claims for CPT 81513 with dates of service March 18-November 17, 2025. Monitor future remittance advice for reprocessed claim results. Billing team should verify eligibility for provider types 12 (Hospital, Outpatient), 43 (Laboratory, Pathology Clinical), and 96 (Rural Emergency Hospital) only.