UCR 284: UTI PCR Under Fire – OIG Scrutiny, Denials, and What to Do Next
About this episode
Scott and Mark Painter discuss the challenges surrounding UTI PCR testing amid OIG scrutiny and payer denials.
April 10, 2026 In this episode, Scott and Mark Painter break down the rapidly evolving and increasingly uncertain landscape surrounding UTI PCR testing, following heightened scrutiny from the OIG and a surge in payer denials—particularly for CPT code 87798. They discuss confusion around MUE limits, shifting interpretations from MACs, and the growing use of N35 denials triggering documentation requests. The episode outlines how practices should respond, including when to appeal, how to s...
People in this episode
Hosts: Scott Painter, Mark Painter
Topics covered
- UTI PCR testing
- OIG scrutiny
- payer denials
- CPT code 87798
- MUE limits
- documentation requests
- appeals process
Keywords
- UTI PCR testing
- OIG scrutiny
- payer denials
- CPT code 87798
- MUE limits
- documentation requests
- appeals process
Mentioned in this episode
Organizations: OIG, MACs, CPT code 87798
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- UCR 286: C9761 Clarified – What Actually Qualifies and What’s at Risk
- UCR 285: Bringing More Complex Procedures Into the Office – Is It Worth It?
- UCR 283: Saturation Biopsy Confusion and Cystoscopy Risk—Where Interpretation Matters
- UCR 282: Playing the Surgical Lottery – Medicare Advantage and Out-of-Network Strategy
- UCR 281: UnitedHealthcare’s New Documentation Rule and MDM Data Clarifications
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