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Bacterial vaginosis is a prevalent condition characterized by an imbalance in the normal bacterial flora of the vagina, leading to symptoms such as unusual discharge, odor, and irritation. It is recognized as the most common cause of vaginitis, which can result in significant health complications if left untreated. These complications include pelvic inflammatory disease, an increased susceptibility to sexually transmitted diseases (STDs), and adverse reproductive outcomes, such as spontaneous abortion and preterm delivery. The procedure associated with CPT® Code 81513 involves a quantitative real-time amplification test that utilizes vaginal fluid specimens to detect specific RNA markers associated with the bacteria Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species. This test employs a technique known as transcription-mediated amplification (TMA), which is an isothermal amplification method that operates at a constant temperature, eliminating the need for thermal cycling. TMA utilizes two enzymes—RNA polymerase and reverse transcriptase—to facilitate the amplification of RNA, resulting in a billion-fold increase in RNA quantity within a short time frame, typically within one hour. The test can also incorporate a chemiluminescent target-specific probe, allowing for real-time molecular detection of the pathogens without the need for washing steps or transferring samples from one tube to another. This efficient process enables the simultaneous detection of multiple pathogenic organisms, and the results are interpreted using a proprietary algorithm that provides a straightforward positive or negative result for bacterial vaginosis.
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The procedure associated with CPT® Code 81513 is indicated for the diagnosis of bacterial vaginosis, which is a common condition that can lead to various health complications. The following conditions and symptoms warrant the use of this test:
The procedure for CPT® Code 81513 involves several key steps to ensure accurate detection of bacterial vaginosis through the analysis of vaginal fluid specimens. The following procedural steps are outlined:
After the completion of the procedure associated with CPT® Code 81513, the patient may not require any specific post-procedure care, as the test is non-invasive and involves only the collection of a vaginal fluid sample. However, it is essential for healthcare providers to communicate the results to the patient promptly. If the result is positive for bacterial vaginosis, appropriate treatment options should be discussed, which may include antibiotics or other therapeutic measures. Additionally, patients should be advised on the importance of follow-up care and monitoring for any recurrent symptoms or complications related to bacterial vaginosis.
| Short Descr | NFCT DS BV RNA VAG FLU ALG | Medium Descr | NFCT DS BACTERAL VAGINOSIS RNA VAGINAL-FLUID ALG | Long Descr | Infectious disease, bacterial vaginosis, quantitative real-time amplification of RNA markers for Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, utilizing vaginal-fluid specimens, algorithm reported as a positive or negative result for bacterial vaginosis | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GA | Waiver of liability statement issued as required by payer policy, individual case | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | SA | Nurse practitioner rendering service in collaboration with a physician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2021-01-01 | Added | Code added. |
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