2025 CPT code 87632
(Active) Effective Date: N/A Infectious Agent Antigen Detection - Microbiology Procedures Pathology and Laboratory Feed
Detection of respiratory viruses using multiplex reverse transcription and amplified probe technique, targeting 6-11 types or subtypes.
Modifiers 59 and 91 are applicable to this code. Modifier 59 is used to indicate a distinct procedural service while modifier 91 is for repeat clinical diagnostic laboratory tests performed on the same day.
Medical necessity for 87632 depends on the patient's clinical presentation and the suspected respiratory viral infection. Symptoms such as fever, cough, shortness of breath, and other respiratory issues justify using the test to guide treatment.
Performed by laboratory personnel. The clinical responsibility includes processing the specimen, performing amplification techniques, assessing the presence of amplified nucleic acid sequences and identifying 6-11 respiratory viruses including adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, or rhinovirus.
In simple words: This test identifies 6 to 11 different respiratory viruses by analyzing their genetic material (DNA or RNA) from a patient sample. It uses advanced techniques to amplify the viral genetic material, making it easier to detect even small amounts of virus. This helps diagnose infections like the common cold, flu, pneumonia, and bronchitis.
Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (e.g., adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 6-11 targets.
Example 1: A patient presents with flu-like symptoms including fever, cough, and sore throat. This test can identify the causative virus, helping to differentiate between influenza, RSV, or other respiratory viruses., An infant experiences bronchiolitis and pneumonia. The test can quickly diagnose RSV infection, guiding appropriate treatment strategies., A patient develops pneumonia after a recent cold. 87632 helps identify the virus responsible for the pneumonia, aiding in targeted therapy and management.
Proper documentation should include the reason for testing, patient symptoms, specimen source, and the specific viruses being targeted.This ensures accurate billing and appropriate clinical decision-making.
** Some payers may reimburse specimen collection separately. It's important to use 87633 if 12-25 viruses are targeted.Ensure correct coding for accurate reimbursement.
- Revenue Code: T1H
- Specialties:Infectious Disease, Pulmonology, Pediatrics, Family Medicine, Internal Medicine
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Independent Laboratory