Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesVirus Isolation ProceduresCPT cpt-87250-viral-isolation-in-embryonated-egg-or-small-animal
    Ask Trek AI about this page

    CPT 87250: Viral Isolation Using Embryonated Egg or Small Animal

    CPT code 87250 describes laboratory viral isolation performed by inoculating an embryo-containing egg or a small animal, allowing the virus to grow, and observing for signs of viral replication, including any necessary dissection; this service is a viral culture/isolation procedure typically performed in a clinical virology laboratory or specialized microbiology lab and represents a diagnostic virology service involving live-animal or embryonated egg inoculation and subsequent observation.

    For related coverage guidance, see recent payer policy updates: Long-Acting Injectable Antiretroviral Agents for HIV, B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays.

    Customize your policy alerts

    Sign up for cpt 87250 policy alerts

    Get alerted when payer policies referencing 87250 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A mid-40s patient presents to a hospital infectious disease laboratory after a clinician suspects a viral etiology for an acute febrile respiratory illness that has not yielded a definitive diagnosis by rapid antigen testing and molecular assays. A respiratory specimen (nasopharyngeal swab or aspirate) or tissue sample is delivered to the virology lab. The virology technologist inoculates the specimen into embryonated eggs or a susceptible small animal model to attempt viral isolation. The sample is incubated and observed over several days for cytopathic effects, embryonic death, or other signs of viral growth; dissection and direct observation may be performed to identify characteristic lesions. Results are used to confirm viable virus, enable further typing, culture-based susceptibility testing, or preparation of isolates for public health reference laboratories.

    Typical site of service: Hospital clinical virology laboratory, public health laboratory, or specialized research/diagnostic laboratory with biosafety facilities.

    Typical patient scenario: A patient hospitalized with pneumonia and worsening hypoxia after negative initial PCR panels, where isolation is pursued to detect unusual or culture-requiring pathogens (for example, certain influenza strains, orthomyxoviruses, or other agents requiring culture for characterization). The laboratory documents specimen accession, inoculation, incubation, observation, and any dissection performed as part of the isolation process.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    87240Infectious agent antigen detection by immunofluorescent technique, direct; single stepPerformed prior to culture to attempt rapid antigen detection and guide need for viral isolation.
    87536Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, includes reverse transcription when performedMolecular testing often precedes or accompanies culture; negative molecular results with high clinical suspicion may prompt culture via 87250.
    87100Cultivation, bacterial, with isolation and presumptive identification of isolatesBacterial culture analogue commonly performed in parallel for differential diagnosis of infection.
    87252Viral serology by immunofluorescent technique (indirect)Serologic testing may be used adjunctively while viral isolation is pursued for definitive identification.
    87420Infectious agent antigen detection by enzyme immunoassay for respiratory syncytial virusExample of rapid antigen testing that may be performed before resorting to viral isolation in eggs or animals.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207R00000X
    174400000X
    163W00000X
    163WX0002X
    171WH0202X
    2080H0002X
    1223X0008X
    171WV0202X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    A08.0Rotaviral enteritis
    A08.4Viral intestinal infection, unspecified
    A41.9Sepsis, unspecified organism
    A49.9Bacterial infection, unspecified
    A92.9Mosquito-borne viral fever, unspecified
    A96.9Arenaviral hemorrhagic fever, unspecified
    B05.9Measles without complication
    B06.9Rubella without complication
    B20Human immunodeficiency virus [HIV] disease
    B26.9Mumps without complication

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    10 rows

    PolicyPayerEffective Date
    Long-Acting Injectable Antiretroviral Agents for HIVColorado Rocky Mountain Health Plans2026-10-01
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01
    Testing for Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01

    Related Codes

    CPT-87252-VIRAL-CULTURE-IDENTIFICATION-TISSUE-CULTURE

    CPT 87252: Viral Isolation in Tissue Culture

    CPT-87253-VIRAL-IDENTIFICATION-AFTER-TISSUE-CULTURE

    CPT 87253: Virus Identification by Neutralization After Tissue Culture

    CPT-87254-SHELL-VIAL-VIRAL-CULTURE-IMMUNOFLUORESCENCE

    CPT 87254: Shell Vial Viral Culture with Immunofluorescence

    CPT-87255-VIRAL-IDENTIFICATION-CELL-IMPACT-ANALYSIS

    CPT 87255: Viral Identification by Cytopathic Effect, Non‑Immunologic

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.