Billing Beat

Decision Memo for Urine Culture Bacterial

April 1, 2004

CMS posted a decision memo regarding the Re-evaluation of Inclusion of Renal Failure in the List of ICD-9-CM Codes Covered. It states the intent (and, therefore, does not constitute a national coverage determination (NCD)) to remove the following ICD-9 CM codes from the list of Medicare covered codes. The subject ICD-9-CM codes are as follows:

584.5 Acute renal failure, with lesion of tubular necrosis
584.9 Acute renal failure, unspecified
585 Chronic renal failure
586 Renal failure, unspecified

Code 585 will be retained, noting that the code only supports bacterial urine culture when the patient is about to undergo renal transplantation.

The transmittal that announces the Coverage Issues Manual revision or program Memorandum will establish the effective date of this policy change.

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