Chart depicting the frequency and median values of various lab tests in urgent care settings, including strep, influenza, and COVID-19 testing.

Top 10 Lab Test CPT Codes in Urgent Care

The healthcare landscape, particularly in urgent care settings, is rapidly evolving towards a more efficient utilization of resources. A significant aspect of this efficiency is the optimization of laboratory test utilization. Leveraging AI medical coding or automated medical coding technologies, especially in urgent care, has become increasingly important. By analyzing the frequency of various lab tests based on CPT® (Current Procedural Terminology) code mapping, insightful patterns and optimization opportunities emerge.
The data provided offers a comprehensive look at the frequency of specific lab tests across different urgent care facilities, distinctly identified by their CPT® codes. This analysis is rooted in examining over 6 Million Claims, providing a robust and extensive dataset. The frequency is expressed in terms of the median value, complemented by the maximum and minimum values observed for each test. This range of utilization not only highlights prevalent testing patterns but also sheds light on areas where efficiency can be enhanced.
Below is a brief analysis of some notable CPT® codes from the shared data:

Analysis of Lab Test CPT Codes in Urgent Care

CPT 87880 - Streptococcus, Group A Detection

The utilization of the test for detecting Streptococcus, group A, varies significantly across urgent care centers, with a frequency range spanning from 13.17 to 31.28. The median frequency is 22.23. This test is performed using an immunoassay with direct visual observation, typically on a throat swab. The variable usage across centers highlights its critical role in diagnosing strep throat, albeit with differing levels of reliance.

CPT 87811 - SARS-CoV-2 Detection

The frequency of the SARS-CoV-2 detection test, essential for COVID-19 diagnosis, shows a high variance in use. Its frequency ranges from 0.00 to 32.48, with a median of 16.24. This test involves an immunoassay-based visual detection method. The wide range of utilization reflects diverse testing strategies for COVID-19 across different urgent care settings.

CPT 81003 - Automated Urinalysis

Automated urinalysis shows a disparate range of use across centers, from 0.00 to 20.43, with a median value of 10.22. This test involves the automated analysis of urine using a dipstick for multiple constituents, excluding microscopy. The disparity in its use indicates variable reliance on this method for urine analysis in urgent care.

CPT 87635 - Nucleic Acid-Based COVID-19 Test

The use of the nucleic acid-based test for COVID-19, utilizing an amplified probe technique, varies markedly among centers, with a frequency range of 0.00 to 19.01 and a median of 9.51. This test is pivotal for precise COVID-19 diagnosis and its varied application suggests different approaches to managing the pandemic across facilities.

CPT 87804 - Influenza Detection

The influenza detection test, performed via immunoassay with visual observation, is consistently used across centers, with a frequency range of 0.10 to 18.12 and a median of 9.11. This test, typically conducted on a throat or nasal swab, is vital for diagnosing influenza and is a standard test in urgent care.

CPT 81025 - Urine Pregnancy Test

The urine pregnancy test, using visual color comparison methods, shows a broad range of utilization from 0.20 to 16.53, with a median frequency of 8.37. This wide range indicates the varied emphasis on pregnancy testing in urgent care scenarios, key for the early detection of pregnancy.

CPT 81002 - Non-Automated Urinalysis

Non-automated urinalysis, performed manually using a dip stick or tablet reagent without microscopy, exhibits varied usage across centers, with frequencies ranging from 0.00 to 8.75 and a median of 4.38. This indicates a preference for manual urine analysis approaches in some urgent care centers.

CPT 87807 - Respiratory Syncytial Virus (RSV) Detection

The test for detecting respiratory syncytial virus (RSV) via visual immunoassay is utilized specifically, with a frequency range of 0.00 to 7.83 and a median of 3.92. This test is crucial for diagnosing RSV infections and its usage is indicative of the specific health needs catered to by different centers.

CPT 85025 - Complete Blood Count (CBC)

The complete blood count (CBC), an essential test for a broad health assessment, shows varying usage across centers, with a frequency range of 0.00 to 5.18 and a median of 2.59. This automated test includes a differential WBC count and is fundamental in many diagnostic processes.

CPT 87651 - Streptococcus, Group A Nucleic Acid Detection

The nucleic acid detection test for Streptococcus, group A, using an amplified probe technique, is less frequently utilized, with a frequency range of 0.00 to 4.20 and a median of 2.10. This test is used for the accurate diagnosis of conditions like strep throat.

How AI Automated Medical Coding is Optimizing Lab CPT Coding in Urgent Care

The integration of medical coding and AI in urgent care centers, pivotal in addressing non-life-threatening but urgent medical conditions, has significantly transformed coding practices.
Currently, the integration of AI medical coding for healthcare facilities has revolutionized the way by which urgent care practitioners, and billing systems manage and process vast amounts of medical data in a few hours.
The utilization of AI in medical coding has become instrumental in streamlining administrative tasks, improving accuracy, and enhancing efficiency in healthcare operations. The emergence of AI-powered medical coding solutions offers a wealth of possibilities. Through machine learning algorithms and advanced data analytics, AI and medical coding assist healthcare professionals in navigating the complexities of clinical coding, ensuring more precise and rapid documentation for billing and compliance purposes.

Resource Allocation & Cost Management in Urgent Care with Automated Medical Coding

  • Resource Allocation with AI Medical Coding:

    AI medical coding systems enable urgent care facilities and urgent care decision-makers to analyze the frequency of various tests and procedures. This analysis helps in correlating the need for specific equipment, supplies, and personnel, facilitating more informed decisions about resource allocation.
  • Application in Optimizing Resources:

    AI medical coding offers advanced data analysis capabilities, allowing urgent care centers to predict demand for services accurately. This predictive capability aids in implementing effective inventory management strategies and staffing solutions, ensuring that resources are optimally utilized to meet patient needs without excess expenditure or waste.
  • Financial Implications of Test Frequency:

    AI medical coding systems provide comprehensive data that helps urgent care decision-makers evaluate the financial implications of frequently conducted tests. This includes understanding the costs associated with these tests and identifying patterns that may indicate opportunities for cost savings.
  • Cost-Saving Strategies via AI Insights:

    Utilizing insights from AI medical coding, urgent care facilities can adopt cost-saving strategies that do not compromise the quality of care. This might include bulk purchasing of supplies for common procedures or implementing more efficient utilization strategies for tests and equipment, all based on data-driven insights provided by the AI coding system.

How XpertCoding is Transforming Urgent Care

XpertCoding is an AI medical coding software that autonomously codes medical claims within twenty-four hours by utilizing machine learning algorithms, natural language processing (NLP), and advanced AI. The platform provides a turnkey, completely automated solution that requires little human oversight.
Through the optimization of the coding procedure, XpertCoding facilitates the expeditious submission of claims with unmatched precision, thereby optimizing financial benefits for clients. Compared to manual coding techniques, it is more effective and efficient due to the sophisticated AI algorithms
The implementation of XpertCoding through the utilization of Robotic Process Automation (RPA) can be achieved within a span of two weeks for any pre-existing Electronic Health Record (EHR) system, and within four weeks for the integration with a new EHR system.
XpertDox has recently established an exclusive collaboration with Urgent Care for Children USA (UC4C), Vybe Urgent Care, and others to offer XpertCoding, a comprehensive automated solution to enhances medical coding efficiency in urgent care.

Salient Features of XpertCoding

Some of XpertCoding's salient characteristics are:
  • 98% Coding Accuracy

  • Less than a 24-hour turnaround time accelerates the revenue cycle.

  • Dashboard that complies with HIPAA regulations, offering performance tracking and an audit trail.

  • Low Variable Cost


This comprehensive analysis reveals the diversity in lab test utilization across urgent care centers. Such variability is influenced by patient demographics, prevalent health issues, and resource availability. Understanding these patterns can lead to more targeted and efficient use of laboratory tests, ultimately enhancing patient care in urgent care settings.
The diverse range of lab test utilization in urgent care settings presents both challenges and opportunities for healthcare providers. Utilizing data-driven approaches, like those offered by XpertCoding, can be transformative. XpertCoding's advanced analytics capabilities allow for the analysis of millions of healthcare claims, offering urgent care organizations deep insights into their lab test utilization patterns. This powerful analysis can decipher trends, inefficiencies, and best practices, enabling these organizations to make informed decisions. By leveraging such comprehensive data, urgent care facilities can optimize their diagnostic processes, improve patient care, and streamline operations. XpertCoding, with its automated medical coding engine, is a pivotal tool in transforming raw data into actionable healthcare insights, guiding urgent care centers toward more efficient and effective patient management.

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