Summary & Overview
CPT 87502: Influenza Virus Detection by Multiplex Nucleic Acid Technique
CPT code 87502 represents a laboratory procedure for detecting influenza virus types and subtypes using advanced nucleic acid techniques. This test is critical for identifying influenza infections, enabling clinicians to differentiate between various strains and subtypes, which is vital for patient management and epidemiological tracking. The code is widely used in clinical laboratories across the United States, reflecting its importance in both routine and outbreak settings.
Major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, provide coverage for this laboratory service. The publication offers insights into payer coverage, relevant policy updates, and clinical context for the use of 87502. Readers will gain an understanding of how this code fits within the broader landscape of infectious disease diagnostics, including its relationship to other influenza testing codes and associated clinical diagnoses. The summary also highlights common billing modifiers and taxonomies relevant to laboratory and pathology services, ensuring stakeholders are informed about coding practices and payer requirements.
This article serves as a comprehensive resource for healthcare professionals, laboratory administrators, and policy analysts seeking to stay current on laboratory coding, payer coverage, and clinical benchmarks for influenza virus detection.
CPT Code Overview
CPT code 87502 is used for the detection of infectious agents by nucleic acid, specifically targeting the influenza virus. This procedure utilizes multiplex reverse transcription and amplified probe techniques to identify each type or subtype of the influenza virus. The service is classified as a laboratory test and is typically performed in a laboratory setting (Place of Service 81). This code is essential for accurate and timely diagnosis of influenza, supporting clinical decision-making and public health surveillance.
Clinical & Coding Specifications
Clinical Context
A patient presents to their primary care provider or urgent care with symptoms suggestive of influenza, such as fever, cough, sore throat, and respiratory distress. The provider orders a laboratory test to detect the presence and subtype of influenza virus using multiplex reverse transcription and amplified probe technique. The specimen, typically a nasopharyngeal swab, is sent to a clinical laboratory (Place of Service 81) for analysis. The laboratory performs the procedure described by CPT code 87502 to identify the specific type or subtype of influenza virus, aiding in diagnosis and guiding treatment decisions.
Coding Specifications
Common Modifiers:
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Modifier
59: Distinct Procedural Service. Used when the procedure is performed separately from other services, indicating it is not part of a bundled service. -
Modifier
91: Repeat Clinical Diagnostic Laboratory Test. Used when the same laboratory test is performed more than once on the same day for the same patient, typically to monitor disease progression or response to treatment.
Associated Provider Taxonomies:
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