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The CPT® Code 87209 refers to a laboratory procedure known as a smear of a primary source with interpretation, specifically utilizing a complex special stain for the identification of ova and parasites. This test is crucial in the diagnostic process as it allows for the detection of various inclusion bodies, parasites, or their eggs in a range of biological specimens. The specimens that may be analyzed include blood, stool, urine, sputum, duodenal aspirate, liver or pancreatic aspirate, cerebrospinal fluid (CSF), nasal secretions, corneal or conjunctival scrapings, and biopsy tissue material. The procedure employs specialized staining techniques, such as trichrome and iron hematoxylin, which enhance the visibility of the target organisms under microscopic examination. The test is particularly significant for identifying a variety of parasitic infections. For instance, blood samples can be examined for malarial parasites, trypanosomes, and microfilaria, while stool and sputum samples may be tested for microsporidia and various parasitic larvae or ova, including those from Ascaris lumbricoides and Strongyloides. Additionally, urine samples can be screened for schistosoma, and aspirates from liver and lung abscesses may be analyzed for Entamoeba histolytica. The process involves drawing blood, typically via a fingerstick, and preparing slides with both thin and thick layers of the sample. Other cell materials are also applied in a thin layer and fixed with heat. After staining, the slides are examined microscopically to identify and count the inclusion bodies, ova, or parasites present, culminating in a comprehensive written report detailing the findings of the analysis.
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The procedure associated with CPT® Code 87209 is indicated for the identification of various parasitic infections and inclusion bodies in multiple biological specimens. The specific indications for performing this test include:
The procedure for CPT® Code 87209 involves several detailed steps to ensure accurate identification of ova and parasites. The process begins with the collection of the biological specimen, which may include blood, stool, urine, sputum, or aspirates from various sites. For blood samples, a fingerstick is typically performed to draw blood, which is then placed on slides in both thin and thick layers. The thin layer is prepared using an inoculation hook to apply the cell material evenly across the slide, which is subsequently fixed with heat to preserve the sample. Once the slides are prepared, they undergo a staining process using complex special stains such as trichrome or iron hematoxylin. These stains enhance the visibility of the target organisms, allowing for better identification under a microscope. After staining, the slides are examined microscopically by a trained laboratory professional. During this examination, the inclusion bodies, ova, or parasites are identified and counted. The findings from this analysis are meticulously documented, resulting in a written report that details the presence and quantity of any identified organisms.
After the completion of the smear and microscopic examination, the laboratory professional compiles a report summarizing the findings. This report is essential for the healthcare provider to make informed decisions regarding patient management and treatment options. There are no specific post-procedure care instructions associated with this test, as it is primarily a laboratory-based procedure. However, it is important for healthcare providers to review the report promptly to initiate any necessary follow-up actions based on the results, which may include further testing or treatment for identified parasitic infections.
| Short Descr | SMEAR COMPLEX STAIN | Medium Descr | SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS | Long Descr | Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites | 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 | 4 | CCS Clinical Classification | 235 - Other Laboratory |
| 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. | 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. | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m 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 | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | 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 | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q4 | Service for ordering/referring physician qualifies as a service exemption | QW | Clia waived test |
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| 2011-01-01 | Changed | Short description changed. |
| 2006-01-01 | Added | First appearance in code book in 2006. |
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