CPT® Code 87260

Official Description

Infectious agent antigen detection by immunofluorescent technique; adenovirus

Common Language Description

The CPT® Code 87260 refers to a laboratory test specifically designed for the detection of adenovirus antigens using an immunofluorescent technique. Adenoviruses are a group of more than 50 viruses that can cause a variety of illnesses in humans, categorized into six distinct species (A-F). These viruses are known to lead to conditions such as gastroenteritis, respiratory illnesses (including colds, croup, bronchitis, and pneumonia), conjunctivitis, hemorrhagic cystitis, and skin rashes. The test is performed on respiratory or fecal samples, which can be collected through various methods. For respiratory samples, collection techniques include nasopharyngeal swabs, aspirates, or washings, as well as bronchoalveolar lavage (BAL) or tracheal aspirates. Fecal samples can be obtained via rectal swabs or stool sampling. During the test, the collected sample is inoculated with antibodies that are specifically conjugated to fluorescein isothiocyanate, a fluorescent dye. The sample is then examined under an epifluorescence microscope. If adenovirus antigens are present, the antibodies will bind to these antigens, resulting in a bright green fluorescence in the cytoplasm and/or nuclei of the infected cells. In contrast, non-infected surrounding cells will exhibit a dull red fluorescence. This immunofluorescent test is valuable for diagnosing acute adenoviral infections and can also help identify asymptomatic carriers, as active adenovirus can be shed in respiratory secretions and feces for extended periods, sometimes lasting weeks or months.

1. Indications

The CPT® Code 87260 is indicated for the detection of adenovirus antigens in patients presenting with symptoms associated with adenoviral infections. The following conditions may warrant the use of this test:

Gastroenteritis - Symptoms may include diarrhea, vomiting, and abdominal pain, particularly associated with adenovirus species A and F.
Respiratory Illness - This includes a range of conditions such as colds, croup, bronchitis, and pneumonia, primarily linked to adenovirus species C, E, and some B species.
Conjunctivitis - Inflammation of the conjunctiva, often caused by adenovirus species D.
Hemorrhagic Cystitis - A condition characterized by inflammation and bleeding in the bladder, associated with adenovirus species B.
Skin Rash - Various rashes may occur due to adenoviral infections, particularly from species B.

2. Procedure

The procedure for the CPT® Code 87260 involves several critical steps to ensure accurate detection of adenovirus antigens. The following procedural steps are outlined:

Sample Collection - A respiratory sample is obtained using methods such as nasopharyngeal swab, aspirate, or washings, or through bronchoalveolar lavage (BAL) or tracheal aspirate. Alternatively, a fecal sample can be collected via rectal swab or stool sampling.
Sample Preparation - The collected sample is then inoculated with adenovirus antibodies that are conjugated to fluorescein isothiocyanate, a fluorescent dye that will bind to the adenovirus antigens if present.
Microscopic Examination - The prepared sample is examined under an epifluorescence microscope. The presence of adenovirus antigens is indicated by a bright green fluorescence in the cytoplasm and/or nuclei of infected cells, while non-infected surrounding cells will show a dull red fluorescence.

3. Post-Procedure

After the procedure, the laboratory will analyze the results and report the findings. If adenovirus antigens are detected, this may confirm an active infection, which can assist in guiding treatment decisions. It is important to note that adenovirus can be shed in respiratory secretions and feces for weeks or even months, which may have implications for infection control and public health measures. Clinicians should consider follow-up testing or monitoring in cases where asymptomatic carriers are identified.

Short Descr	ADENOVIRUS AG IF
Medium Descr	IAADI ADENOVIRUS
Long Descr	Infectious agent antigen detection by immunofluorescent technique; adenovirus
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	1
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.
GV	Attending physician not employed or paid under arrangement by the patient's hospice provider
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.