CPT 87493: Clostridium difficile Toxin Gene Detection, Amplified Probe
CPT code 87493 represents a molecular diagnostic assay that detects the Clostridium difficile toxin gene using an amplified nucleic acid probe technique. This assay provides rapid, sensitive identification of C. difficile, a leading cause of healthcare-associated diarrhea and colitis; timely detection has implications for infection control, patient management, and public health surveillance nationwide. Major payers relevant to this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of clinical context and appropriate site-of-service settings for the test, along with typical payer coverage considerations and billing nuances. The publication presents benchmarking data where available, notes recent policy and coding updates affecting molecular infectious disease testing, and summarizes common clinical indications for ordering the assay. The content is intended to equip billing managers, laboratory directors, and health policy analysts with a clear understanding of what CPT code 87493 denotes, how it is used in practice, and the payer landscape for reimbursement and coverage determinations. Data not available in the input is identified as such in relevant sections.
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Billing Code Overview
CPT code 87493 describes a laboratory test that detects the Clostridium difficile toxin gene using an amplified nucleic acid probe technique. This molecular diagnostic identifies the presence of the gene associated with C. difficile toxins, a common cause of hospital-acquired diarrhea and colitis.
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Service type: Molecular diagnostic infectious disease test using amplified nucleic acid probe technique
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Typical site of service: Hospital laboratory, clinical laboratory, or other certified diagnostic laboratory performing inpatient and outpatient testing