2025 CPT code 87503
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Microbiology Procedures Pathology and Laboratory Feed
This add-on code is used for the detection of additional influenza virus types or subtypes beyond the first two using nucleic acid detection.
Yes, modifiers 59 and 91 can apply.
Medical necessity for this code must be supported by the patient's signs, symptoms, and clinical picture suggesting infection with multiple influenza strains. Public health surveillance and epidemiological considerations may also factor into medical necessity.
Laboratory professionals perform the technical steps to detect each additional influenza virus type or subtype beyond two.It includes multiplex reverse transcription and multiplex amplified probe technique.
In simple words: This lab test helps identify different types of the flu virus using a genetic test. It's used when doctors need to check for more than two types of flu at the same time.
Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, each additional influenza virus type or sub-type beyond 2 (List separately in addition to code for primary procedure)
Example 1: A patient presents with flu-like symptoms, and the physician suspects infection with multiple influenza strains. 87502 is billed for the first two subtypes identified, and 87503 is billed for each additional subtype detected., During a flu outbreak, a hospital uses multiplex testing to identify circulating strains. A patient's sample is positive for three different influenza subtypes. 87502 is billed for the first two subtypes and 87503 is used once for the third subtype. , A research study investigates influenza co-infections. A patient sample tests positive for two influenza A subtypes and one influenza B subtype. 87502 is reported for the two influenza A subtypes and 87503 is reported once for the influenza B subtype.
Documentation should support medical necessity for testing multiple influenza types/subtypes. Results of the nucleic acid detection test, including the specific types/subtypes identified, should be documented.
** Molecular diagnostic codes (e.g., 81161, 81200-81408) should not be reported with 87503.
- Payment Status: Active
- Specialties:Pathology, Infectious Disease, Internal Medicine
- Place of Service:Independent Laboratory, Hospital Laboratory