2025 CPT code 87798
(Active) Effective Date: N/A Infectious Agent Detection - Microbiology Procedures Pathology and Laboratory Procedures Feed
Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism.
Modifiers 59, 90, 91, XU and others are applicable.
Medical necessity is established when other diagnostic tests have failed to identify a suspected infectious agent, especially in cases of persistent infections, unusual symptoms, or weakened immune systems.
The laboratory analyst collects the sample, extracts nucleic acid, amplifies it through processes such as PCR, and performs hybridization and detection using labeled probes. The test is used when other tests are inconclusive or a rare infectious agent is suspected.
In simple words: This test helps identify infections when other tests have been unsuccessful. It uses a technique called "amplified probe technique" to look for tiny traces of germs in a sample like blood or saliva, identifying the infectious agent's genetic material.This is especially helpful in detecting unusual or difficult-to-find infections.
This code represents a laboratory test using amplified nucleic acid probe technology to detect infectious agents not identified by other specific codes. It involves amplifying the target nucleic acid sequence (DNA or RNA) from the collected specimen and then using a labeled probe to identify the presence of the infectious agent.
Example 1: A patient presents with persistent fever and cough, but routine tests for common respiratory pathogens are negative. Code 87798 is used to detect less common or novel respiratory viruses., A patient with a compromised immune system develops an unusual infection. This test is used to identify the cause when standard tests don't provide a diagnosis., An outbreak of an unknown infectious disease occurs.87798 helps identify the causative agent in such scenarios.
Documentation must include the reason for ordering the test, the type of specimen collected, the amplified probe technique employed, and the results.Details about previous negative test results for common pathogens should also be included when relevant.
** Some payers may separately reimburse specimen collection (e.g., 36415 for venipuncture). This code should not be used when a more specific code for the infectious agent is available.The use of this code can vary based on payer policies.
- Revenue Code: T1H (LAB TESTS - OTHER)
- Payment Status: Active
- Specialties:Pathology, Infectious Disease, Clinical Microbiology
- Place of Service:Independent Laboratory, Hospital Inpatient/Outpatient