2025 CPT code 87797
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Microbiology Procedures Pathology and Laboratory Feed
Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism.
Modifiers 59 (distinct procedural service) and 91 (repeat test) may be applicable. Consult payer guidelines for additional modifier rules.
Medical necessity is determined by the physician based on the patient's clinical presentation, symptoms, and the need to identify an infectious agent not detectable by routine testing.The physician should document the clinical rationale for ordering the test.
The clinical laboratory performs the test. Ordering physician is responsible for medical necessity and interpretation of results in patient management.
In simple words: This lab test checks for an infection by looking for specific genetic material from the germ causing the infection.It uses a special technique to detect the germ's DNA or RNA. This is used when a more specific test for a particular germ isn't available.
This CPT code, 87797, represents the detection of an infectious agent using a direct nucleic acid probe technique.The test identifies the presence of specific nucleic acid sequences indicative of an infectious agent not otherwise specified in the CPT codebook. The procedure involves preparing a specimen, mixing it with a single-stranded DNA or RNA probe (labeled for visualization), and observing hybridization—the binding of the probe to complementary sequences in the specimen. This code is used when a specific infectious agent code is unavailable, and the direct probe technique is employed.
Example 1: A patient presents with a persistent fever and symptoms suggestive of an unusual infection. Standard microbiology cultures are negative. The physician orders code 87797 to investigate the possibility of a less common infectious agent using a direct nucleic acid probe., A patient returns to the clinic with a recurring infection, previously treated with antibiotics.To determine if the infection has mutated or a new infection is present, the physician orders 87797 to detect specific DNA or RNA sequences using the direct probe technique., A research study is being conducted on a new emerging infectious agent for which there is not yet a specific CPT code available for a direct nucleic acid probe test.Code 87797 is used to report the direct probe technique to detect the suspected organism.
Physician order specifying the direct nucleic acid probe technique, patient demographics, specimen source and collection date, complete lab results, and clinical correlation by the physician.
** This code is for use only when no other more specific CPT code exists for detecting the infectious agent using a direct nucleic acid probe technique.Always check for specific codes before using 87797.The use of this code may be subject to payer-specific coverage policies and medical necessity reviews.
- Revenue Code: T1H (LAB TESTS - OTHER)
- RVU: Information not available in provided text.RVUs vary by payer and location. Check with your specific payer for current RVU values.
- Global Days: Not applicable.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Information not available in provided text. Historical fee schedules vary by payer and location.
- Specialties:Infectious Disease, Microbiology, Pathology
- Place of Service:Laboratory, Hospital, Physician Office