Summary & Overview

CPT 87149: DNA/RNA Probe Analysis for Organism Typing

CPT code 87149 identifies a molecular laboratory procedure that uses direct DNA or RNA probe techniques to further characterize an already isolated and identified organism, often to a more specific taxonomic level. This procedural code matters nationally because it supports precise microbial identification that can guide public health surveillance, infection control, and targeted antimicrobial strategies. Payers commonly involved in coverage and reimbursement discussions for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise overview of clinical context and the role of molecular probe testing in organism typing, along with national benchmarking and payer coverage considerations. The publication outlines typical sites of service and service type, summarizes common modifier usage where available, and highlights how this code interacts with laboratory workflows. It also covers policy updates and payer expectations relevant to molecular diagnostic billing, reimbursement patterns, and documentation practices. Data not available in the input are noted explicitly where applicable (for example, associated taxonomies, specific ICD-10 diagnoses, and related codes).

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare87149CPTMolecular diagnosticsMicrobiologyDNA probeRNA probeLaboratory servicesOrganism typing

Billing Code Overview

CPT code 87149 describes a laboratory procedure in which a lab analyst performs an analysis using a direct DNA or RNA probe technique on a previously isolated and identified organism to further categorize the organism more specifically (for example, to the taxonomic level of type). The service type is molecular diagnostic/refinement testing performed on an isolated microbial specimen. The typical site of service is a clinical or reference laboratory setting where isolated organisms are available for specialized molecular analysis.

Clinical & Coding Specifications

Clinical Context

A clinical microbiology laboratory receives an organism previously isolated from a patient specimen (for example blood culture, wound swab, urine, or respiratory specimen). The lab analyst performs a direct DNA or RNA probe analysis (87149) to further categorize the organism to a more specific taxonomic level (such as type) after primary identification by culture and preliminary biochemical or mass spectrometry testing. A typical patient scenario: an adult hospitalized patient with sepsis has a positive blood culture that grows Gram-positive cocci; initial identification suggests Streptococcus species and the lab performs a direct nucleic acid probe to determine the specific type for epidemiology and targeted antimicrobial guidance. Workflow: isolate organism → confirm identity with routine methods (culture, MALDI-TOF) → perform direct DNA/RNA probe (87149) on the previously isolated organism → document probe results in the microbiology report → communicate results to treating team for infection control, antibiotic selection, and public health reporting as applicable.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional interpretation component of a test if the laboratory separates technical and professional components.
`59`	Distinct procedural service	Use when this probe analysis is distinct and separate from other services on the same day that would otherwise be bundled.
`62`	Two surgeons (or two qualified providers)	Use when two qualified laboratory physicians or directors perform portions of the testing that meet payer rules for two-provider billing.
`90`	Reference (outside) laboratory	Use when the test was sent to an outside/reference laboratory and the billing facility indicates that external lab performed the analysis.
`91`	Repeat clinical diagnostic laboratory test	Use when the same probe test is repeated on the same specimen to confirm results within a short interval.
`52`	Reduced services	Use when the test was partially reduced or not fully performed compared with the full procedure.
`53`	Discontinued procedure	Use when performance of the test was started but discontinued for patient or specimen-related reasons.
`76`	Repeat procedure by same physician (use `91` for lab tests)	Not typically used for this code; include here for clarity that `91` is preferred for repeat lab tests.
`78`	Unplanned return to OR by same physician (limited applicability)	Rarely applicable; may be used in complex surgical pathology workflows where microbial typing affects intraoperative management.
`91`	Repeat clinical diagnostic laboratory test	(See above) Repetition for confirmation or QC purposes.

Taxonomy Code	Specialty	Notes
`406QM0800X`	Pathology and Laboratory Medicine	Clinical microbiologists and medical directors overseeing molecular probe testing.
`207RH0000X`	Infectious Disease	Infectious disease physicians who order organism typing for patient management and public health.
`363L00000X`	Clinical Laboratory	Clinical laboratory scientists/technologists who perform the direct probe analysis.
`2080P0212X`	Pediatrics	Pediatric infectious disease specialists ordering organism typing in pediatric patients.
`207P00000X`	Preventive Medicine	Public health/microbiology specialists involved in epidemiologic typing and reporting.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87077`	Culture, bacterial; urine, with isolation and presumptive identification of isolates	Often performed prior to `87149` when the organism is first isolated from clinical specimens.
`87070`	Culture, bacterial; blood, aerobic and anaerobic bottles, includes isolation and presumptive identification	Blood culture isolation that frequently precedes molecular typing with `87149`.
`87471`	Infectious agent antigen detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique, each organism	Represents organism-specific nucleic acid tests that may be used either as alternatives or complements to direct probe typing.
`87490`	Infectious agent detection by nucleic acid (DNA or RNA), multiplex, first organism	Multiplex molecular panels that may detect and type organisms and can be performed before or alongside targeted probe testing.
`87150`	Direct fluorescent antibody technique for identification of microorganisms; per organism	Alternative direct identification methods that may be used in conjunction with or instead of nucleic acid probe (`87149`).