Summary & Overview
CPT 87507: Multiplex Nucleic Acid Test for Gastrointestinal Pathogens
CPT code 87507 represents a multiplex nucleic acid amplification test that detects 12–25 gastrointestinal pathogens or subtypes, including common bacterial, viral, and parasitic agents. This molecular diagnostic panel is clinically important for rapid, comprehensive identification of infectious causes of acute gastroenteritis, which can guide infection control, public health reporting, and targeted patient management. Nationally, adoption of multiplex molecular panels has grown as laboratories and clinicians seek faster, more sensitive diagnostics compared with traditional culture or single-target assays.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, coding and billing considerations, and clinical context relevant to laboratory and hospital billing teams. Readers will find benchmarks for utilization and reimbursement where available, summaries of relevant policy trends, and practical context for interpreting the clinical role of this panel in acute gastrointestinal illness evaluation. Data not available in the input will be noted as such. The content is intended to inform billing, compliance, and laboratory operations stakeholders about the service profile and payer landscape for CPT code 87507 at a national level.
Billing Code Overview
CPT code 87507 describes a laboratory nucleic acid test that detects 12 to 25 types or subtypes of gastrointestinal pathogens (for example, Clostridium difficile, Escherichia coli, Salmonella, Shigella, norovirus, Giardia). The procedure uses nucleic acid detection methods and may include multiplex reverse transcription and multiplex amplified probe techniques.
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Service type: Multiplex nucleic acid amplification testing for gastrointestinal pathogens
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Typical site of service: Clinical laboratory or hospital-based laboratory performing molecular diagnostic testing
Clinical & Coding Specifications
Clinical Context
A 42-year-old adult presents to the outpatient urgent care clinic with three days of acute, watery diarrhea, abdominal cramping, low-grade fever, and recent onset of nausea after a meal at a restaurant. The clinician obtains a stool specimen to evaluate for infectious gastroenteritis. The specimen is sent to the laboratory for a multiplex nucleic acid amplification test that detects 12–25 gastrointestinal pathogens and subtypes (bacterial, viral, and parasitic) using multiplex reverse transcription and amplified probe techniques.
In the laboratory workflow, a certified medical technologist or lab analyst receives the stool specimen, performs nucleic acid extraction, runs the multiplex assay per manufacturer instructions, interprets the multiplex panel results, and documents positive or negative pathogen detections in the electronic laboratory record. Results are released to the ordering clinician for targeted therapy or infection control decisions. Typical site of service is outpatient clinic/urgent care, hospital-based laboratory, or independent reference laboratory; testing can also be ordered in the emergency department or inpatient settings when evaluation of infectious diarrhea is required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional interpretation or reporting component of testing provided by laboratory personnel separate from technical service. |