Summary & Overview
CPT 87271: Cytomegalovirus Antigen Detection by DFA
CPT code 87271 identifies a direct fluorescent antibody (DFA) laboratory test used to detect Cytomegalovirus (CMV) antigens in clinical specimens. This diagnostic assay provides rapid, specific evidence of active CMV infection and is clinically important in immunocompromised patients, neonates, and transplant recipients where timely detection affects clinical management. Nationally, CPT code 87271 is relevant for laboratory billing, test utilization monitoring, and policies on infectious disease diagnostics. Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description of the test, its typical laboratory setting, and the common contexts in which the assay is ordered. The publication presents national-level benchmarks where available, coding and billing considerations tied to CPT code 87271, and the clinical context that informs appropriate use of DFA-based CMV antigen testing. Where input data is lacking, the report marks fields as unavailable rather than inferring details. The content is intended to support billing staff, laboratory managers, and policy analysts seeking a clear, national overview of CPT code 87271 and its role in diagnostic workflows.
Billing Code Overview
CPT code 87271 describes a laboratory test in which a clinical lab analyst detects Cytomegalovirus (CMV) antigens using the direct fluorescent antibody (DFA) technique. This test identifies viral antigens in patient specimens by applying fluorescent-labeled antibodies and examining the specimen under a fluorescence microscope.
Service Type: Infectious disease diagnostic laboratory test (direct antigen detection)
Typical Site of Service: Clinical laboratory or hospital laboratory
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 6-week-old neonate presents to the hospital neonatal intensive care unit with petechial rash, hepatosplenomegaly, and transaminitis. The neonate was born to a mother with suspected primary Cytomegalovirus infection during pregnancy. A clinician orders laboratory testing on a urine and nasopharyngeal specimen to detect active CMV infection using a direct fluorescent antibody technique. A laboratory technologist performs 87271 (direct fluorescent antibody, CMV antigen) on the specimen. The workflow includes specimen receipt and accessioning, preparation of slides and reagents, staining with CMV-specific fluorescent-labeled antibodies, microscopic examination by the lab analyst, documentation of positive or negative antigen detection, and reporting of results to the ordering pediatric infectious disease clinician and the hospital electronic medical record system.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician or laboratorian professional interpretation portion of a split service |
59 | Distinct procedural service | When another diagnostic test is performed on the same day and the CMV DFA is a distinct service
62 | Two surgeons | If two qualified laboratorians with distinct roles are required for a complex testing process (rare)
78 | Unplanned return to the operating/procedure room | Not typically applicable; included when an unplanned repeat intra-procedure test is required immediately
80 | Assistant surgeon | Not typically applicable for lab-only services but used when an assisting professional provides a required component
90 | Reference (outside) laboratory | When the specimen is sent to an outside reference laboratory for performance of 87271
TC | Technical component | When billing only the laboratory technical component (equipment, reagents, technician work)
QX | Modifier indicating clinician performed the non-physician practitioner's services were furnished by a CRNA (specific to anesthesia) | Rarely applicable; included only if regulatory reporting or payer requires
QY | Attending practitioner of record in teaching setting | Use when a resident performs portions under supervision and payer recognition of teaching physician rules applies
59 | Distinct procedural service | Use when test is separate and independent from other services billed on the same day
| Taxonomy Code | Specialty | Notes |
|---|---|---|
0000A | Clinical Laboratory Scientist / Medical Technologist | Performs specimen processing and DFA staining and microscopy |
0000B | Pathology / Clinical Pathology | Laboratory medical director oversight and result validation
0000C | Infectious Disease | Ordering and interpreting physician for pediatric or neonatal CMV diagnosis
0000D | Pediatrics / Neonatology | Ordering clinician and clinical team managing the neonate
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
P35.1 | Congenital cytomegalovirus infection | Primary diagnosis indicating congenital CMV; direct indication for 87271 antigen testing |
B25.9 | Cytomegaloviral disease, unspecified | Diagnosis for active CMV disease where antigen detection can support clinical assessment
R53.1 | Weakness | Non-specific symptom that may prompt broader infectious workup including CMV testing in infants
R17 | Unspecified jaundice | Neonatal jaundice can be a manifestation of congenital CMV and prompt antigen testing
P59.9 | Neonatal jaundice, unspecified | Used when evaluating neonatal hyperbilirubinemia potentially related to CMV infection
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
87270 | Smear, primary staining for bacteria by direct fluorescent antibody technique (e.g., Legionella, Chlamydia) | Similar direct fluorescent antibody methodology; sometimes performed in the same laboratory workflow when multiplex DFA panels are used |
87440 | Infectious agent antigen detection by immunoassay technique; adenovirus | Alternate antigen detection methods for viral pathogens; used when antigen immunoassays are preferred or available
87499 | Unlisted miscellaneous pathology procedure | Used rarely when a codable antigen detection test is not available or when unique testing methodology requires unlisted coding
87070 | Culture, bacterial, with isolation and presumptive identification | May be ordered concurrently for evaluation of concurrent bacterial infection in neonates