Summary & Overview
CPT 87490: Chlamydia trachomatis Direct Nucleic Acid Probe Test
CPT code 87490 denotes a laboratory diagnostic test using a direct nucleic acid probe to detect Chlamydia trachomatis, the pathogen responsible for a common sexually transmitted infection and certain eye infections. This molecular technique is an established diagnostic modality that supports timely identification and public health surveillance of chlamydial infection. Nationally, such tests influence clinical decision-making for treatment, contact tracing, and prevention of complications.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise outline of the clinical context for the test, typical sites of service, and the service type. The publication also summarizes benchmarking and coverage considerations across major payers, highlights policy or coding updates when relevant, and lists associated billing elements for operational reference.
This report is intended to inform billing managers, lab administrators, and policy analysts about the role of CPT code 87490 in clinical workflows and payer interactions. Data not available in the input are explicitly omitted; the focus is on the code definition, clinical implications, payer coverage scope, and practical billing metadata.
Billing Code Overview
CPT code 87490 describes a laboratory test in which a lab analyst performs a direct nucleic acid probe technique to detect Chlamydia trachomatis. The procedure identifies genetic material specific to the bacterium that causes common sexually transmitted infections and some ocular infections.
Service Type: Diagnostic laboratory testing — molecular direct probe
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A sexually active 22-year-old female presents to an outpatient clinic with new-onset abnormal vaginal discharge and pelvic discomfort. The clinician performs a focused history and pelvic exam, collects an endocervical swab (or vaginal swab) specimen, and sends the sample to the laboratory for nucleic acid probe testing specifically for Chlamydia trachomatis. The laboratory analyst performs a direct nucleic acid probe assay, documents specimen acceptability, runs the assay according to manufacturer instructions, interprets results, and reports a positive or negative result to the ordering clinician. Positive results prompt partner notification and treatment per local public health guidance; negative results with persistent symptoms may lead to additional testing such as nucleic acid amplification tests (NAAT) or testing for other sexually transmitted infections.
Typical site of service: outpatient clinic or ambulatory care laboratory, sexually transmitted infection (STI) clinic, urgent care, or hospital outpatient laboratory.
Service type: laboratory diagnostic test — direct nucleic acid probe detection of Chlamydia trachomatis performed by a laboratory analyst.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional component of a test when the lab facility reports technical separately and a physician interprets results. |