Summary & Overview
CPT 87269: Immunofluorescent Detection of Giardia Antigen
CPT code 87269 denotes an immunofluorescent laboratory assay performed to detect Giardia antigens, a targeted parasitology diagnostic used to confirm giardiasis. This code is used nationally across clinical and hospital laboratories and matters for clinical diagnosis, infection control, and public health surveillance where timely, specific parasitic identification alters treatment and containment decisions. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on the clinical purpose of the code, expected sites of service, and payer coverage landscape. The publication also presents operational benchmarks relevant to laboratory billing for immunofluorescent parasitology testing, summaries of payer policy themes affecting coverage and prior authorization, and clinical context explaining when immunofluorescent testing for Giardia is typically used versus other diagnostic methods. Data limitations are noted where input fields are not provided. The piece is intended for laboratory managers, billing professionals, and policy analysts needing a focused reference on CPT code 87269 and its role in diagnostic workflows and payer interactions.
Billing Code Overview
CPT code 87269 describes a laboratory test in which a lab analyst performs an immunofluorescent assay to detect Giardia antigens. The service is a parasitology diagnostic test that uses immunofluorescence techniques to identify presence of Giardia organisms in clinical specimens.
Service Type: Laboratory / Diagnostic Test
Typical Site of Service: Clinical laboratory or hospital laboratory
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or pediatric patient presenting to an outpatient clinic, urgent care, emergency department, or hospital with acute gastroenteritis — symptoms include watery diarrhea, abdominal cramping, nausea, vomiting, and occasionally low-grade fever and weight loss. The clinician collects a stool specimen or orders a stool antigen test when Giardia lamblia (Giardia intestinalis) infection is suspected based on recent travel history, daycare exposure, contaminated water exposure, or persistent steatorrhea. The specimen is sent to the clinical laboratory. A medical laboratory scientist or technologist performs an immunofluorescent assay to detect Giardia antigens in the stool; the test involves reagent incubation, microscopic fluorescent reading, and documentation of results. Results are reported to the ordering provider for treatment decisions, such as initiation of antiprotozoal therapy or public health precautions. Typical sites of service include outpatient laboratories, hospital clinical laboratories, emergency departments, urgent care centers, and reference laboratories.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal, standard service | When the immunofluorescent Giardia antigen test is performed under typical circumstances without unusual procedural issues |
22 |