2025 CPT code 87801
Effective Date: N/A Pathology and Laboratory Procedures - Microbiology Procedures Feed
Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique.
Modifiers 59, 90, and 91 may be applicable in specific circumstances as outlined in the coding guidelines.
Medical necessity must be supported by the patient's clinical presentation and suspected infectious etiology. Documentation should link the test to the signs, symptoms, and working diagnosis, justifying the need to test for multiple organisms concurrently.
The lab analyst processes the specimen and performs the amplified probe technique. This involves amplification of nucleic acid sequences, hybridization with labeled probes, and visualization of results.
In simple words: This test checks for multiple infections at once using a technique that amplifies DNA or RNA. A sample is collected, and then a process called PCR makes millions of copies of specific parts of the DNA/RNA. These copies are then checked using special probes that can identify the presence of different infections.
This code represents a single test that involves multiple probes for multiple organisms. The lab analyst processes the specimen from a direct source (e.g., sputum, pleural fluid, throat swab, nasopharyngeal washings) and performs amplification techniques (e.g., polymerase chain reaction (PCR)) to increase the number of copies of specific target nucleic acid sequences. Then, the analyst assesses the presence of the amplified sequences using a nucleic acid probe, a fabricated single-strand sequence of DNA or RNA, to identify the presence of infectious agents. The probes have labels (radioactive or chemical) for visualization.
Example 1: A patient with suspected pneumonia has a sputum sample tested for multiple bacterial and viral pathogens using 87801., A patient with a complicated urinary tract infection has a urine sample analyzed for multiple resistant organisms using 87801., A patient with suspected meningitis has cerebrospinal fluid tested for multiple bacterial and viral causes using 87801.
The documentation should include the type of specimen, the source of the specimen, the specific infectious agents being tested for, and the results of the test. It should also specify that multiple organisms are targeted in a single assay utilizing amplified probes.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- Specialties:Pathology, Infectious Disease, potentially any specialty ordering the test.
- Place of Service:Independent Laboratory, Outpatient Hospital, potentially others depending on where the test is performed.