2025 CPT code 87561
Effective Date: N/A Pathology and Laboratory Procedures > Microbiology Procedures Feed
Infectious agent detection by nucleic acid (DNA or RNA); Mycobacterium avium-intracellulare, amplified probe technique
Modifiers 59 and 91 are applicable as described in the coding guidelines.
Medical necessity for 87561 is established by the presence of signs, symptoms, or conditions suggestive of an MAI infection, particularly in immunocompromised individuals. This may include pulmonary symptoms, joint inflammation, or other systemic findings.
The lab analyst processes the specimen, performs amplification techniques (like PCR), and uses a nucleic acid probe to detect the presence of MAI. They interpret the results to determine whether the bacteria is present in the sample.
In simple words: This test checks for a type of bacteria called Mycobacterium avium intracellulare (MAI) in a sample like blood or sputum. The lab makes many copies of the bacteria's genetic material (DNA or RNA) if it's present, making it easier to detect. A special "probe" is used to find the bacteria’s genetic material. This probe has a tag that makes it visible so the lab can see if the bacteria is there.
This code represents a laboratory test for Mycobacterium avium intracellulare (MAI) using an amplified nucleic acid probe technique. The process involves amplifying the target nucleic acid sequence (DNA or RNA) from the specimen and then using a labeled probe to detect the presence of MAI. Amplification techniques such as PCR create millions of copies of the target sequence, making detection easier. The probe, a single-stranded sequence of DNA or RNA, hybridizes with the complementary sequence in the specimen. The label on the probe allows visualization of the results, indicating the presence or absence of MAI.
Example 1: A patient with compromised immunity presents with lung symptoms suggestive of MAI infection. An 87561 test is performed on a sputum sample to confirm the diagnosis., A patient with suspected joint inflammation (synovitis or tenosynovitis) undergoes testing for MAI using the amplified probe technique (87561) on a synovial fluid sample., A patient with signs of a systemic infection, such as swollen lymph nodes or bone marrow abnormalities, has an 87561 test performed on a blood sample to detect or rule out MAI.
Documentation should include the type of specimen collected (e.g., blood, sputum, synovial fluid), the reason for the test (e.g., symptoms, suspected infection), and the result of the amplified probe technique.
- Revenue Code: T1H
- Specialties:Microbiology, Infectious Disease, Pulmonology, Rheumatology
- Place of Service:Independent Laboratory, Hospital Inpatient, Hospital Outpatient, Office