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The CPT® Code 87168 refers to the macroscopic examination of arthropods, which are invertebrate animals that have an exoskeleton, segmented body, and jointed appendages. This examination is specifically aimed at identifying disease-causing arthropods, such as lice and ticks, which can pose significant health risks to patients. The procedure involves a thorough visual inspection of the patient to detect the presence of these parasites, which may lead to various health issues, including skin irritations, allergic reactions, and the transmission of infectious diseases. It is important to differentiate this examination from other types of parasite evaluations, such as those for non-arthropod parasites, which are coded under CPT® Code 87169. The macroscopic examination is a critical step in diagnosing and managing conditions associated with arthropod infestations, ensuring that appropriate treatment can be initiated based on the findings of the examination.
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The macroscopic examination coded under CPT® 87168 is indicated for patients who may be suffering from infestations by disease-causing arthropods. The following conditions or symptoms may warrant this examination:
The procedure for the macroscopic examination of arthropods involves several key steps to ensure a thorough evaluation of the patient:
After the macroscopic examination, the patient may receive specific instructions based on the findings. If an infestation is confirmed, the provider will discuss treatment options, which may include topical or oral medications to eliminate the arthropods. Patients may also be advised on preventive measures to avoid future infestations, such as maintaining personal hygiene and avoiding environments where arthropods are prevalent. Follow-up appointments may be scheduled to assess the effectiveness of the treatment and ensure that the infestation has been resolved. Additionally, patients should be informed about potential symptoms to monitor after the examination, particularly if they experience any adverse reactions to treatments or if symptoms persist.
| Short Descr | MACROSCOPIC EXAM ARTHROPOD | Medium Descr | MACROSCOPIC EXAMINATION ARTHROPOD | Long Descr | Macroscopic examination; arthropod | 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) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 2 | CCS Clinical Classification | 206 - Microscopic examination (bacterial smear, culture, toxicology) |
| 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. | 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. | 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. | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2001-01-01 | Added | First appearance in code book in 2001. |
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