CPT 87561: Mycobacterium avium-intracellulare Amplified Probe Test
CPT code 87561 represents a molecular diagnostic assay that uses an amplified nucleic acid probe to detect Mycobacterium avium intracellulare (MAI), a clinically significant nontuberculous mycobacterial pathogen. This laboratory procedure supports diagnosis and management of suspected mycobacterial infections and is performed in clinical and hospital laboratories with molecular testing capability. Nationally, accurate identification of MAI affects infectious disease management, infection control, and antimicrobial stewardship, making this code relevant for laboratory billing and public health reporting.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical application of the test, typical sites of service, and which payers are considered in coverage discussions. The publication outlines billing benchmarks, reimbursement context, and policy considerations relevant to laboratory services for MAI detection, along with clinical context that helps connect coding to diagnostic decision-making. Data not available in the input will be noted where applicable.
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Billing Code Overview
CPT code 87561 describes a laboratory test that detects Mycobacterium avium intracellulare (MAI) using an amplified nucleic acid probe technique. The procedure identifies mycobacteria, a group of bacteria often referred to as acid-fast organisms due to the special staining characteristics used for visualization.
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Service type: Molecular diagnostic amplified nucleic acid probe test for MAI
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Typical site of service: Hospital or commercial clinical laboratory; performed on microbiology or molecular diagnostics platforms
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