2025 CPT code 87260
(Active) Effective Date: N/A Revision Date: N/A Infectious Agent Antigen Detection - Microbiology Procedures Pathology and Laboratory Procedures Feed
Detects adenovirus antigens using immunofluorescent techniques on a primary source specimen.
Modifiers 59 (distinct procedural service) and 91 (repeat clinical diagnostic laboratory test) are applicable.
Medical necessity is established when there is a clinical suspicion of adenovirus infection based on the patient's symptoms and/or medical history. The test helps confirm or rule out the diagnosis and guide treatment decisions.
The clinical responsibility lies with the laboratory personnel who perform the technical aspects of the test and interpret the results. The ordering physician is responsible for appropriate medical decision-making based on the test results and the patient’s clinical presentation.
In simple words: This lab test checks for adenovirus, a type of virus, in a sample from your body (like a nasal swab).The lab uses special dyes that glow under a microscope to see if the virus is present, helping doctors diagnose infections like colds or other adenovirus-related illnesses.
This CPT code, 87260, represents the detection of adenovirus antigens using immunofluorescence techniques.The procedure involves analyzing a primary source specimen (e.g., nasal swab, bronchial brushing) to identify the presence of specific adenovirus antigens via immunofluorescence microscopy.The process includes mixing fluorescently tagged antibodies with the specimen and examining the slides under a fluorescence microscope.Interpretation is based on the fluorescence staining patterns.This test aids in diagnosing or ruling out adenovirus infections linked to respiratory diseases, conjunctivitis, gastrointestinal issues, or other related conditions.This code is specifically for primary source specimens; it is not used for testing culture isolates.If testing involves multiple species or strains, use modifier 59. For repeat tests on the same day, use modifier 91.
Example 1: A patient presents with symptoms suggestive of an adenovirus respiratory infection (cough, fever, sore throat). A nasal swab is collected and sent to the laboratory for adenovirus antigen detection using immunofluorescence. The results are reported to the physician, informing the management plan., A child presents with conjunctivitis (pink eye). A conjunctival swab is obtained and tested for adenovirus antigen using immunofluorescence.The test is positive, supporting a diagnosis of adenoviral conjunctivitis., A patient with suspected adenoviral gastroenteritis has a stool sample tested using immunofluorescence for adenovirus antigens.The results are negative, prompting further investigation into other potential causes of the gastrointestinal symptoms.
* Patient demographics and identifying information* Clinical indication for the test (e.g., symptoms, suspected diagnosis)* Specimen type and collection date/time* Detailed description of the laboratory procedure performed* Results interpretation
** Always report the most specific code possible.If no specific agent code exists for a particular adenovirus strain, use the appropriate unlisted code (e.g., 87999).
- Revenue Code: T1H (LAB TESTS - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Infectious Disease, Pediatrics, Pathology, Microbiology, Family Medicine
- Place of Service:Office, Hospital (Inpatient and Outpatient), Laboratory