Summary & Overview
CPT 87910: CMV Genotype Analysis by Nucleic Acid
CPT code 87910 represents a molecular diagnostic laboratory test: the technical laboratory analysis of cytomegalovirus (CMV) genotype using nucleic acid methods. This code is used when laboratory personnel perform the technical component of CMV genotyping to characterize viral genetic variants. CMV genotype testing supports clinical care in immunocompromised patients, transplant recipients, and neonates, and informs infection management, resistance surveillance, and public health tracking.
Key payers considered in national coverage and reimbursement contexts include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and payment rates for CMV genotyping can vary by payer and setting; readers should expect differences in lab reimbursement, prior authorization requirements, and medical necessity criteria among commercial plans and Medicare.
This publication provides an overview of CPT code 87910, including clinical context for CMV genotyping, typical sites of service, payer coverage landscape, and the kinds of benchmarks and policy details readers will find in the full report. The full content addresses reimbursement benchmarks, common modifier use and billing considerations, and clinical scenarios where CMV genotyping is applied. Data not available in the input is noted where specific payer policy details, associated taxonomies, and related codes would otherwise be listed.
Billing Code Overview
CPT code 87910 describes a technical laboratory procedure in which a lab analyst performs nucleic acid testing to analyze the genotype of cytomegalovirus (CMV). This service is a molecular diagnostic test focused on identifying CMV genetic variants that can inform clinical interpretation of infection, resistance, or epidemiology.
Service type: Molecular diagnostic laboratory test (technical component)
Typical site of service: Clinical laboratory or hospital laboratory (inpatient or outpatient specimen processing)
Clinical & Coding Specifications
Clinical Context
A 34-year-old pregnant patient presents with symptoms suggestive of primary cytomegalovirus (CMV) infection or exposure (fever, malaise, abnormal fetal ultrasound findings such as ventriculomegaly or intracranial calcifications). Maternal blood or amniotic fluid is submitted to the molecular diagnostics laboratory for nucleic acid–based CMV genotyping. The laboratory analyst performs 87910 to analyze CMV genotype by nucleic acid testing, including extraction, amplification, sequencing or targeted genotyping, and data interpretation on the technical side. Typical workflow: specimen accessioning → nucleic acid extraction → PCR amplification and genotyping/sequencing → technical result verification and reporting of laboratory (technical) findings to the ordering clinician. Typical sites of service include hospital clinical laboratories, independent reference laboratories, and outpatient diagnostic laboratories supporting prenatal, neonatal, transplant, and immunocompromised patient care scenarios.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing the professional interpretation/sequencing analysis by a pathologist or laboratory director separate from the technical component |
TC |