Summary & Overview
CPT 87472: Nucleic Acid Quantification for Bartonella henselae and quintana
CPT code 87472 designates a nucleic acid probe test to quantify infection with Bartonella henselae and Bartonella quintana. This molecular diagnostic code captures specialized laboratory testing used in clinical evaluation of suspected Bartonella infection, an important but relatively uncommon vector-borne and zoonotic disease. Accurate identification and quantification can influence clinical management and public health reporting, making this code relevant for hospital and reference laboratory billing nationally. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for the test, typical sites of service, and payer coverage considerations. The publication provides benchmarks for utilization and reimbursement patterns when available, notes recent policy updates affecting molecular diagnostics billing, and summarizes common billing practices and documentation expectations. Where input data is not provided, the text notes that data is not available in the input. The content is intended for coding, billing, and laboratory management professionals seeking a national overview of how CPT code 87472 is described and applied in practice.
Billing Code Overview
CPT code 87472 describes a laboratory procedure in which a laboratory analyst performs a nucleic acid probe technique to quantify infection with Bartonella henselae and Bartonella quintana. The service is a molecular diagnostic test that detects and measures nucleic acid targets specific to these Bartonella species.
Service Type: Molecular diagnostic laboratory test (nucleic acid probe quantification)
Typical Site of Service: Clinical laboratory or hospital laboratory setting
Clinical & Coding Specifications
Clinical Context
A 34-year-old patient presents to an outpatient infectious disease clinic with a two-week history of fever, malaise, regional lymphadenopathy after a recent cat scratch. The clinician documents suspicion for cat-scratch disease or bartonellosis and orders laboratory testing to detect and quantify DNA from Bartonella henselae and Bartonella quintana using nucleic acid probe-based methods. A phlebotomy technician collects a blood specimen and forwards it to the molecular diagnostics laboratory. In the lab, a molecular technologist extracts nucleic acids and performs the nucleic acid probe technique to detect and quantify Bartonella species. The laboratory analyst interprets the assay result and issues a report to the ordering provider. Typical sites of service include outpatient clinic collection with testing performed in a certified hospital or independent clinical molecular laboratory. The service is billable under the laboratory CPT code 87472 for quantification of Bartonella henselae and Bartonella quintana by nucleic acid probe technique.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional component (interpretation) if the lab separates technical and professional components. |