Summary & Overview
CPT 87276: Influenza A Immunofluorescent Antigen Detection
CPT code 87276 denotes an immunofluorescent antibody staining assay with fluorescence microscopy to detect influenza A virus antigens. This laboratory-based diagnostic procedure is clinically important for timely identification of influenza A, informing infection control and clinical decision-making across inpatient and outpatient settings. Nationally, accurate coding of such tests influences surveillance, reporting, and reimbursement for laboratory services.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for antigen-based influenza testing, payer coverage patterns, and where CPT 87276 fits among laboratory diagnostic services. The publication outlines typical sites of service and operational considerations for laboratories offering immunofluorescent antigen detection.
The report provides benchmarks and policy context relevant to CPT code 87276, including common billing practices and coding considerations for labs and billing teams. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 87276 describes a laboratory test in which a clinical laboratory analyst detects influenza A virus antigens using immunofluorescent antibody staining and fluorescence microscopy. This assay is a type of infectious disease antigen detection performed by trained laboratory personnel to identify viral proteins from respiratory specimens.
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Service type: Laboratory diagnostic test (immunofluorescent antigen detection)
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Typical site of service: Hospital clinical laboratory, specialized reference laboratory, or outpatient laboratory facility where microscopy and fluorescence immunostaining are performed.
Clinical & Coding Specifications
Clinical Context
A 6-year-old child presents to an urgent care clinic in winter with acute onset fever, cough, nasal congestion, myalgia, and lethargy for 24 hours. A clinician performs a focused respiratory exam and obtains a nasopharyngeal swab. The specimen is sent to the on-site laboratory where a medical laboratory scientist prepares a slide and performs an immunofluorescent antibody stain to detect influenza A viral antigens. The lab analyst examines the slide under fluorescence microscopy and documents positive or negative antigen staining, reporting results to the ordering clinician to guide antiviral therapy decisions and infection control precautions. Typical workflow steps: specimen collection, accessioning, reagent preparation, immunofluorescent staining, fluorescence microscopy interpretation, result verification, and electronic reporting to the clinician and the medical record. Typical site of service: hospital laboratory, hospital outpatient laboratory, or an urgent care/clinic laboratory performing in-house rapid immunofluorescence testing. Service type: laboratory diagnostic immunofluorescent antigen detection.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician or laboratorian interpretation/reading of the fluorescence microscopy separate from technical services |
TC |