CG-LAB-24 Outpatient Urine Culture

This policy addresses outpatient urine culture testing for bacteria. It is medically necessary to evaluate suspected UTI with clinical signs or symptoms, when urinalysis is abnormal suggesting UTI, for asymptomatic bacteriuria in pregnant persons, or when bacteriuria is present prior to an endoscopic urologic procedure; all other uses are not medically necessary. Coverage is limited to outpatient bacterial urine cultures and does not include routine screening outside these criteria.

"Outpatient urine culture testing for bacteria is consideredmedically necessaryto evaluate any of the following situations:"

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