Summary & Overview
CPT 87850: Gonorrhea Immunoassay, Direct Optical (Visual) Read
CPT code 87850 designates a laboratory immunoassay with direct optical (visual) observation for detection of Neisseria gonorrhoeae. This code represents the technical laboratory procedure in which a lab analyst processes a specimen and visually interprets immunoassay results to determine presence or absence of gonococcal antigen. Nationally, accurate coding for gonorrhea testing is important for surveillance, public health reporting, and aligning reimbursement with laboratory workflows.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of clinical context for gonorrhea immunoassays, coding nuances for the technical component, and payer coverage considerations. Readers will find benchmarks for typical sites of service and service type, summaries of payer coverage patterns where available, and a clear description of the procedure the code represents.
This summary focuses on the clinical and billing identity of the code, its role in diagnostic workflows for sexually transmitted infection testing, and the payer landscape relevant to clinicians, laboratory managers, and billing professionals. Data not available in the input is noted where applicable in later sections.
Billing Code Overview
CPT code 87850 describes a laboratory immunoassay with direct optical (visual) observation performed by a lab analyst to detect the presence of Neisseria gonorrhoeae in a clinical specimen. The procedure is a qualitative diagnostic immunoassay where the technical component consists of preparing and processing the specimen and visually interpreting the assay result.
Service Type: Laboratory diagnostic test — immunoassay, visual read
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A sexually active adult presents to a primary care clinic or sexual health clinic with urethral or cervical discharge, dysuria, pelvic pain, or after a known exposure to a partner with a sexually transmitted infection. A clinician obtains a swab (urethral, endocervical, vaginal) or urine specimen and sends it to the laboratory for an immunoassay-based direct optical test for Neisseria gonorrhoeae. The lab analyst performs 87850 to detect gonococcal antigen using a visual immunoassay technique. Results are reported back to the ordering provider; a positive result prompts partner notification and targeted therapy per local treatment guidelines, while a negative result may lead to additional testing such as NAAT depending on clinical suspicion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional (interpretation) portion if separated from the technical component. |
| 59 | Distinct procedural service | Use when 87850 is a distinct test from another lab test performed on the same date that would otherwise be bundled.
| | Technical component | Use when billing only the technical component (laboratory performance) of .