CPT 87581: Mycoplasma pneumoniae Nucleic Acid Probe Test
CPT code 87581 represents a molecular diagnostic assay for Mycoplasma pneumoniae using an amplified nucleic acid probe. This code is used to report laboratory testing that detects a bacterial respiratory pathogen through nucleic acid amplification and probe-based detection — a clinically important method for diagnosing atypical pneumonia and guiding appropriate treatment. Nationally, such molecular assays matter because they offer rapid, sensitive detection that can influence antibiotic stewardship and patient management across care settings.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, common billing modifiers, and payer coverage patterns where available. The publication also summarizes benchmarking information and policy considerations relevant to laboratory billing, reimbursement coding accuracy, and documentation practices.
The material is intended to help coding professionals, laboratory administrators, and billing managers understand how CPT code 87581 is applied, what clinical scenarios prompt its use, and what operational and policy elements affect billing and reimbursement. Data not available in the input are clearly noted where applicable.
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Billing Code Overview
CPT code 87581 describes a laboratory test that detects Mycoplasma pneumoniae using an amplified nucleic acid probe technique. The procedure involves a lab analyst performing molecular amplification and detection to identify the presence of the bacterial pathogen.
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Service type: Molecular diagnostic test (nucleic acid amplification and probe detection)
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Typical site of service: Clinical laboratory or hospital laboratory performing molecular diagnostic testing