2025 CPT code 87149
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Microbiology Procedures Pathology and Laboratory Feed
Identification of microorganisms using direct nucleic acid (DNA or RNA) probe techniques on a previously isolated culture.
Modifiers 59 (distinct procedural service) and 91 (repeat test) may apply, depending on the clinical circumstances.
Medical necessity for this test is established when the physician requires more specific identification of a previously isolated microorganism to guide treatment decisions, particularly in cases of recurrent infections, severe infections, or infections resistant to common antibiotics. The specific clinical context necessitates this additional level of identification beyond genus and species.Payer policies and guidelines should always be consulted.
The clinical responsibility lies with the ordering physician who determines the need for the test based on the patient's clinical presentation and the need for precise identification of a microorganism. The clinical laboratory performs the test and reports the results to the physician. The physician interprets the results and uses them to inform diagnosis and treatment decisions.
In simple words: This lab test uses a special technique to identify a type of germ that's already been found in a sample. It's like a more precise test to get more specific information about the germ.
This CPT code, 87149, represents the identification of a microorganism to the type level using direct nucleic acid (DNA or RNA) probe techniques. This procedure involves analyzing a previously isolated and identified organism (usually to the genus and species level, billed separately) from a culture to determine its specific type.The test utilizes molecular methods but should not be reported with other molecular pathology codes (e.g., 81161, 81200-81408).It is specifically for direct probes on culture isolates; different codes apply if probes are used on direct smears.Multiple specimens or sites require modifier 59; repeat testing on the same day requires modifier 91.
Example 1: A patient presents with a suspected bacterial infection.After initial culture and identification of the organism as Staphylococcus aureus to the species level (billed using 87077), a direct DNA probe is used to determine the specific strain (e.g., methicillin-resistant Staphylococcus aureus - MRSA), which is then reported using 87149. , A patient with a recurrent urinary tract infection has a culture performed.The isolate is identified as Escherichia coli.Further typing using 87149 helps determine if the infection is caused by a specific strain resistant to certain antibiotics, guiding treatment decisions. , A patient undergoes surgery, and a postoperative wound infection develops.The isolated bacterium is identified as Pseudomonas aeruginosa. To determine the specific strain and its antibiotic resistance profile, a direct RNA probe is used (87149), enabling targeted therapy to combat the infection. This is crucial for the selection of appropriate antibiotics.
* Patient demographics and unique identifiers.* Physician's order specifying the test.* Specimen collection date and time.* Specimen type (e.g., culture isolate).* Results of prior microbiology tests (e.g., culture, gram stain, biochemical tests).* Detailed report of the nucleic acid probe test results, including the specific probe used and the identification of the microorganism to the type level.
** This code is specifically for direct nucleic acid probes on culture isolates.Ensure the isolate has already been identified to the genus and species level before using 87149.Consult with the laboratory for specific testing methods and reporting requirements.
- Revenue Code: T1H (LAB TESTS - OTHER)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Microbiology, Infectious Disease, Pathology
- Place of Service:Office, Hospital, Laboratory