2025 CPT code 87635
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Laboratory - Microbiology Procedures Pathology and Laboratory Procedures > Microbiology Procedures Feed
Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), amplified probe technique.
Modifiers 59 (distinct procedural service) and 91 (repeat test) may be applicable depending on the clinical scenario.
Medical necessity for this test is established by the presence of symptoms suggestive of COVID-19, exposure to a confirmed case, or for diagnostic purposes in patients with respiratory illness.
Laboratory personnel are responsible for specimen processing, nucleic acid amplification, probe hybridization, and result interpretation.
In simple words: This lab test checks for the virus that causes COVID-19 using a special technique to find its genetic material (DNA or RNA). The lab makes many copies of the virus's genetic material and then looks for it using a special marker.
This CPT code reports the detection of the SARS-CoV-2 virus, the causative agent of COVID-19, using an amplified nucleic acid probe technique.The laboratory analyst processes a specimen (e.g., throat swab, sputum, respiratory secretions), amplifies the target nucleic acid sequence (e.g., using PCR), and then detects the amplified sequences using a labeled nucleic acid probe via hybridization.Reverse transcription, if performed, is included. This code does not include testing for SARS-CoV-2 antibodies (see codes 86328 and 86769).
Example 1: A patient presents with symptoms of COVID-19 (fever, cough, shortness of breath). A nasopharyngeal swab is collected, and the sample is sent to a laboratory for SARS-CoV-2 testing using code 87635., A healthcare worker is exposed to a confirmed COVID-19 case. A nasopharyngeal swab is collected for SARS-CoV-2 testing (code 87635) to determine if they have contracted the virus., A patient is admitted to the hospital with pneumonia.As part of the diagnostic workup, a SARS-CoV-2 test (code 87635) is ordered to rule out COVID-19 as the cause of the pneumonia.
Properly labeled specimen, patient demographics, date and time of collection, test requisition form indicating the test ordered, results of the test.
** This code was rapidly developed in response to the COVID-19 pandemic.Always check for the latest coding guidelines and payer-specific policies.
- Revenue Code: T1H (LAB TESTS - OTHER)
- RVU: Information not available in provided text.Refer to current fee schedules for RVU values.
- Global Days: Not applicable
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Information not available in provided text. Refer to historical fee schedules for past payment information.
- Specialties:Clinical Microbiology, Infectious Disease, Pathology
- Place of Service:Office, Hospital, Clinical Laboratory, Other Place of Service