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CPT 87220: KOH Microscopic Fungal Examination
CPT code 87220 represents a microscopic fungal examination using potassium hydroxide (KOH) to detect fungal elements in specimens such as nail clippings, skin scrapings, or hair shafts. This relatively simple, low-cost laboratory procedure plays a key role in diagnosing dermatophyte and other superficial fungal infections and often guides antifungal treatment decisions. It is widely used across outpatient clinics, dermatology practices, and clinical laboratories, making it an important procedure in ambulatory and laboratory service utilization.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of CPT code 87220, the typical sites where the service is performed, and the common contexts in which clinicians order a KOH preparation. The publication also outlines benchmarking topics and policy considerations relevant to laboratory billing and coverage, including typical use cases and how the test fits into diagnostic workflows. Data not available in the input will be noted where applicable.
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Billing Code Overview
CPT code 87220 describes a laboratory micologic examination in which a lab analyst or microbiologist adds potassium hydroxide (KOH) as a clearing agent and examines a specimen for fungal elements. The procedure is typically performed on nail clippings, skin scrapings, or hair shaft specimens to detect dermatophytes and other fungal forms.
Service Type: Microscopic fungal examination (KOH preparation)
Typical Site of Service: Clinical laboratory, hospital laboratory, or outpatient clinic specimen-processing area
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