Summary & Overview
CPT 87492: Chlamydia trachomatis Quantitative Nucleic Acid Probe Test
CPT code 87492 represents a quantified nucleic acid probe test for Chlamydia trachomatis, a common sexually transmitted bacterium that also causes certain ocular infections. The code captures a laboratory assay performed by an analyst to detect and quantify Chlamydia trachomatis genetic material using probe-based nucleic acid methods. This test supports diagnosis, treatment decisions, and public health surveillance for chlamydial infection.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national perspective on clinical context, typical sites of service, and the role of nucleic acid probe testing in managing sexually transmitted and ocular chlamydial infections. The publication outlines common billing considerations, prevalent modifier usage (provided in input), and how this laboratory service integrates with clinical workflows.
The report provides benchmarks where available, summarizes relevant policy and coverage themes for major payers, and situates CPT code 87492 within diagnostic testing practice. Data not available in the input will be noted as such in detailed sections.
Billing Code Overview
CPT code 87492 describes a laboratory procedure in which a lab analyst performs a nucleic acid probe test to quantify infection with Chlamydia trachomatis. The test detects and measures the presence of Chlamydia trachomatis genetic material using probe-based nucleic acid techniques.
Service type: Infectious disease diagnostic laboratory test (nucleic acid probe, quantitative)
Typical site of service: Clinical laboratory or hospital laboratory; specimen collection may occur in outpatient clinics, sexual health clinics, or ophthalmology settings for eye infections
Clinical & Coding Specifications
Clinical Context
A sexually active adult female presents to a primary care clinic with dysuria, vaginal discharge, and pelvic pain. The clinician performs a focused sexual health history and pelvic exam, collects a cervical or vaginal swab (or first-catch urine for nucleic acid testing), and sends the specimen to the laboratory for nucleic acid probe testing to detect and quantify infection with Chlamydia trachomatis. The laboratory analyst processes the specimen using a nucleic acid probe technique and reports a quantitative result to the ordering clinician. Typical workflow steps include specimen collection at the outpatient clinic or STI clinic, specimen labeling and transport to the clinical laboratory, performance of the 87492 nucleic acid probe assay by laboratory personnel, quality control and verification, and result reporting into the electronic health record for clinical follow-up and treatment decisions. Typical site of service is an outpatient clinic, sexual health/STI clinic, or hospital outpatient laboratory. Common clinical scenarios also include screening of asymptomatic patients during routine sexual health visits, testing of symptomatic patients with cervicitis or urethritis, and testing of neonates or infants with conjunctivitis when ocular Chlamydia infection is suspected.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the professional interpretation component separate from the technical component |