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. |
52 | Reduced services | Use when the test is partially performed or a limited panel is run compared with full service. |
53 | Discontinued procedure | Use when testing was started but discontinued for clinical reasons before completion. |
59 | Distinct procedural service | Use to indicate a separate, distinct test or service performed at a different session or specimen when bundling edits would otherwise apply. |
62 | Two surgeons (co-surgeon) | Rare for this lab test; use only if two qualified providers share responsibility for the professional interpretation in a complex institutional arrangement. |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure | Not commonly applicable; may be used if an immediate repeat specimen collection and testing is performed intra-procedurally. |
90 | Reference (outside) laboratory | Use when the test is sent to an outside/reference laboratory for performance. |
91 | Repeat clinical diagnostic laboratory test | Use when an identical test is repeated on the same day to confirm results. |
TC | Technical component | Use when reporting only the technical component (instrumentation, reagents, technician work) of the test. |
QK | CLIA waived test performed by laboratory technician | Use when applicable for personnel certification-specific reporting in certain payor arrangements. |
QX | Qualified nonphysician laboratory director | Use when tests are performed in a laboratory overseen by a qualified nonphysician director as permitted by regulations. |
QY | Laboratory director under CLIA of an alternative provider type | Use when appropriate for payor reporting tied to laboratory director qualifications. |
90 | Reference (outside) laboratory (duplicate entry) | See above entry for 90. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207Q00000X | Clinical Laboratory Director | Laboratory directors overseeing molecular diagnostic testing. |
| 2080P0004X | Clinical Pathology | Pathologists who interpret diagnostic laboratory testing and manage lab services. |
| 362M00000X | Clinical Laboratory Technologist/Medical Technologist | Personnel who perform nucleic acid testing and run multiplex assays. |
| 207L00000X | Infectious Disease Specialist | Clinicians ordering targeted pathogen panels and interpreting clinical implications. |
| 207LG0400X | Gastroenterology | Clinicians who frequently evaluate patients with infectious diarrhea and order stool panels. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
A09 | Infectious gastroenteritis and colitis, unspecified | Common presenting diagnosis when a multiplex stool NAAT is ordered to identify a causative pathogen. |
A04.5 | Enteropathogenic Escherichia coli infection | E. coli subtypes are detected on multiplex GI pathogen panels; relevant when diarrheal illness suggests bacterial enteropathogens. |
A00 | Cholera | Bacterial causes of severe watery diarrhea; certain panels include pathogens of public health importance. |
A02.0 | Salmonella enteritis | Salmonella species are commonly targeted pathogens on multiplex panels for infectious diarrhea. |
A03 | Shigellosis | Shigella species cause acute dysentery and are included in comprehensive GI pathogen NAAT panels. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
87476 | Infectious agent antigen detection by immunoassay with direct optical observation; Clostridium difficile (e.g., toxin) | Alternative or adjunct stool test for Clostridium difficile when antigen/toxin testing is performed instead of or prior to multiplex NAAT. |
87449 | Infectious agent detection by nucleic acid (e.g., PCR), multiple organisms; amplified probe technique, multiple organisms, 3–5 targets (example) | Smaller, targeted molecular panels that may be ordered when fewer organisms are suspected; less comprehensive than the 12–25 target panel. |
87045 | Culture, bacterial; stool, ova and parasites (includes culture for bacterial enteropathogens) | Traditional stool culture performed alongside molecular testing for organisms not included on NAAT panels or for antimicrobial susceptibility testing. |
G0476 | Infectious agent detection by nucleic acid (NAAT) for multiple pathogens (alternate lab panel G-code used by some payors) | Payor-specific laboratory panel code sometimes used for multiplex gastrointestinal pathogen panels in certain billing scenarios. |
87802 | Infectious agent antigen detection by enzyme immunoassay for multiple organisms (non-molecular multiplex antigen panels) | Non-molecular multiplex antigen tests that might be used in parallel or as rapid screening tests prior to or instead of molecular panels. |