2025 CPT code 87899
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Microbiology Procedures Pathology and Laboratory Procedures Feed
Infectious agent antigen detection by immunoassay with direct optical observation; not otherwise specified.
Modifiers 59 (distinct procedural service) and 91 (repeat clinical diagnostic laboratory test) may be applicable. Refer to CPT guidelines for appropriate modifier usage.
Medical necessity for this test is determined by the clinician based on the patient's clinical presentation, symptoms, and risk factors for infection. The test should be ordered when there is a clinical suspicion of infection but the specific pathogen is not known or identifiable through more specific tests.
The clinical responsibility for this test lies with the laboratory personnel who perform the immunoassay and interpret the results. The ordering physician is responsible for determining the medical necessity for the test and integrating the results into the patient's overall care.
In simple words: This lab test checks for infections by using a method that shows a visible change (like a color change) if an infection is present.It's used when the type of infection isn't known yet.
This CPT code, 87899, represents the detection of an infectious agent antigen using an immunoassay technique with direct optical (visual) observation.The method involves mixing a patient specimen with a reagent containing antibodies specific to the infectious agent.A visual change, such as a color shift or line appearance, indicates a positive result. This code is used when the infectious organism cannot be identified by other, more specific, laboratory tests.
Example 1: A patient presents with symptoms suggestive of a bacterial infection (fever, cough, etc.).A sample (e.g., sputum, blood) is collected and tested using an immunoassay. If the specific bacteria cannot be identified by more specific tests, 87899 may be reported., A patient is suspected to have a viral infection and blood is analyzed using an immunoassay with direct optical observation.This code is appropriate if the specific virus isn't identified by other assays., A rapid diagnostic test is performed in a physician's office.The test involves a visual color change on a reagent strip to detect the presence of a general viral antigen. If a more specific code is not available, 87899 may be appropriate.
* Patient demographics and relevant clinical information.* Specimen type and collection date and time.* Detailed description of the immunoassay method used.* Results of the immunoassay (qualitative and/or quantitative).* Interpretation of the results and any follow-up testing performed.* Physician's order for the test indicating medical necessity.
** This code is often used for rapid diagnostic tests performed at the point of care.The specific immunoassay method may vary depending on the laboratory and the type of infection suspected. Always verify with your payer for specific coverage and reimbursement policies.
- Revenue Code: T1H (LAB TESTS - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Clinical Microbiology, Infectious Disease, Pathology
- Place of Service:Office, Hospital (inpatient/outpatient), Laboratory, Urgent Care Facility