2025 CPT code 87497
Effective Date: N/A Pathology and Laboratory Procedures - Microbiology Procedures Feed
Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification
Modifiers may be applicable. Modifier 59 is used for distinct procedural services, and modifier 91 is used for repeat laboratory tests performed on the same day.
Medical necessity is established by the clinical indication for the test, such as suspected CMV infection in a vulnerable population (newborns, immunocompromised individuals) or monitoring of CMV infection in transplant recipients.
The lab analyst processes the specimen, performs amplification techniques (e.g., PCR), and uses a labeled nucleic acid probe to quantify the CMV nucleic acid in the sample.
In simple words: This lab test measures the amount of cytomegalovirus (CMV) in a sample like blood or body fluid. CMV is a common virus that can cause serious problems for newborns and people with weakened immune systems. The test helps doctors diagnose CMV and track how well treatment is working.
This test quantifies cytomegalovirus (CMV) infection using nucleic acid probe technique. The lab analyst processes the specimen (e.g., blood, body fluids, or tissue) and performs amplification techniques (e.g., polymerase chain reaction (PCR)) to increase the number of copies of a specific target nucleic acid sequence. Then, they assess the number of microorganisms present by evaluating the amplified nucleic acid sequences that indicate the presence of cytomegalovirus using a labeled nucleic acid probe. This probe hybridizes with the complementary sequence in the specimen, allowing visualization and quantification of the hybridization product. This test is typically used to diagnose and monitor CMV infection, especially in newborns and immunocompromised patients.
Example 1: A newborn exhibiting symptoms of CMV infection (e.g., jaundice, hearing loss) requires a quantitative CMV test to confirm the diagnosis and assess the severity of the infection., An HIV-positive patient with fever and pneumonia undergoes a CMV quantification test to determine if CMV reactivation is contributing to their symptoms., An organ transplant recipient is monitored regularly with CMV quantification tests to detect early signs of CMV reactivation and initiate preemptive treatment.
Documentation should include the reason for testing, the source of the specimen, and any relevant clinical findings.
- Revenue Code: T1H - LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE)
- Specialties:Infectious Disease, Immunology, Neonatology, Transplant Surgery
- Place of Service:Independent Laboratory, Hospital (Inpatient and Outpatient), and other applicable facilities