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    v1.0.30
    OpenPayerBilling CodesVirus Isolation ProceduresCPT cpt-87255-viral-identification-cell-impact-analysis
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    CPT 87255: Viral Identification by Cytopathic Effect, Non‑Immunologic

    CPT code 87255 describes a laboratory procedure in which a lab analyst identifies a virus using non‑immunologic methods that evaluate the virus's cytopathic effect on cultured cells; this is a specialized virology diagnostic test typically performed in a clinical virology laboratory or microbiology reference lab and classified as a laboratory service involving cell culture observation rather than antigen/antibody assays.

    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.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A middle-aged adult presents to an outpatient infectious disease laboratory with symptoms of an acute viral illness such as fever, malaise, and respiratory or enteric symptoms. A clinical specimen (e.g., nasopharyngeal swab, stool, or tissue culture) is sent to the virology lab for identification of an etiologic virus using non-immunologic methods that evaluate viral effects on cultured cells (cytopathic effect) and/or alternative molecular/virus identification techniques described by the test method. The lab analyst receives the specimen, documents specimen integrity and labeling, inoculates appropriate cell cultures or performs other specified non-immunologic viral identification methods, incubates and monitors cultures for cytopathic changes, and performs confirmatory testing (e.g., molecular sequencing or PCR-based assays if part of the technique) to identify the viral species or strain. Results are reported to the ordering clinician, such as an infectious disease specialist, pediatrician, hospitalist, or primary care provider, for clinical correlation and management.

    Typical site of service: Hospital clinical virology laboratory, reference laboratory, or academic medical center virology lab.

    Typical patient scenario: An adult with worsening cough and hypoxia after outpatient treatment; a nasopharyngeal swab is submitted for viral identification to guide antiviral therapy and infection control. The lab performs culture-based observation of cytopathic effect and molecular confirmation consistent with the described methodology.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    87255Identification of virus by methods other than immunologic assays or evaluation of cytopathic effect that involves observing how a virus impacts and damages cellsPrimary code describing laboratory identification of virus using non-immunologic, culture-based or equivalent methods.
    87631Infectious agent detection by nucleic acid (DNA or RNA); SARS-CoV-2, amplified probe techniqueCommon molecular test performed before, alongside, or after culture-based methods for faster detection and confirmation.
    87661Infectious agent detection by nucleic acid (DNA or RNA); influenza A and B, includes multiplex panelsFrequently ordered in respiratory illness workups; may be used in parallel to or prior to culture-based identification.
    87471Infectious agent antigen detection by immunoassay; influenza ARapid antigen or immunologic assays are often performed as initial testing; culture-based identification is used for confirmation or strain typing.
    87507Infectious agent antibody; viral serology (e.g., enteric viruses)Serologic testing can complement culture results for diagnosis of acute or recent infection.

    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…
    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…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    208000000X
    174400000X
    2084P0301X
    251300000X
    1223X0400X
    2278C0205X
    364SI0800X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    A08.39Other viral enteritis
    A08.4Viral intestinal infection, unspecified
    A49.2Hemophilus influenzae infection, unspecified site
    A90Dengue fever [classical dengue]
    A92.9Mosquito-borne viral fever, unspecified
    B00.9Herpesviral infection, unspecified
    B05.9Measles without complication
    B06.9Rubella without complication
    B15.9Hepatitis A without hepatic coma
    B16.9Acute hepatitis B without delta-agent and without hepatic coma

    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-87250-VIRAL-ISOLATION-IN-EMBRYONATED-EGG-OR-SMALL-ANIMAL

    CPT 87250: Viral Isolation Using Embryonated Egg or Small Animal

    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

    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.
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