CPT 87500: Detection of Vancomycin Resistance Genes (Amplified Probe)
CPT code 87500 represents a molecular diagnostic laboratory test that uses an amplified probe technique to detect vancomycin resistance genes, most commonly Van A and Van B in vancomycin-resistant enterococcus (VRE). This test is clinically important because rapid identification of VRE informs infection control measures and antimicrobial stewardship, and it is increasingly used in hospital and laboratory settings for surveillance and diagnostic purposes.
Key national payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for CPT code 87500, common payer coverage considerations, and practical billing information such as typical service setting and related billing elements. The publication summarizes benchmarking and reimbursement context, highlights policy developments affecting molecular infectious disease testing, and outlines operational considerations for laboratories and hospital billing departments.
The content focuses on national implications rather than state-specific rules. Where detailed payer-specific policies or rates are not available in the input, the publication notes that data is not available and directs readers to payer policies for coverage specifics.
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Billing Code Overview
CPT code 87500 describes a laboratory molecular diagnostic test that detects vancomycin resistance genes (Van A and Van B) in an infectious organism’s nucleic acid using an amplified probe technique. The test identifies vancomycin-resistant enterococcus (VRE) and other organisms that harbor genetic markers conferring vancomycin resistance.
Service Type: Molecular diagnostic infectious disease testing (amplified probe technique)
Typical Site of Service: Clinical laboratory or hospital laboratory
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