CPT® Code 87271

Official Description

Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA)

Common Language Description

The CPT® Code 87271 refers to a laboratory test specifically designed for the detection of cytomegalovirus (CMV) antigens in body fluid samples through the use of the direct fluorescent antibody (DFA) technique. Cytomegalovirus is a member of the herpesvirus family and is known to infect a significant portion of the population, with most individuals being infected by the age of 40. While the infection is typically mild and may present with symptoms such as fever, sore throat, fatigue, lymphadenopathy, and occasionally an enlarged liver and/or spleen, it poses a greater risk to individuals who are immunocompromised, who may experience more severe manifestations of the disease. The virus can be found in various bodily fluids, including blood, saliva, tears, urine, semen, and breast milk, and is capable of crossing the placenta, potentially leading to congenital CMV infection in the fetus. This congenital infection can have serious implications, affecting the brain, liver, spleen, and lungs of the affected newborns. Transmission of CMV occurs through direct contact with infected bodily fluids, sexual contact, breast milk, blood transfusions, and organ transplants. The testing process involves obtaining a sample of blood or other body fluids, which is then inoculated with CMV antibodies that are conjugated to fluorescein isothiocyanate. The sample is examined under an epifluorescence microscope; if CMV antigens are present, the antibodies will bind to them, resulting in a bright green staining of the nuclei, while non-infected surrounding cells will exhibit a dull red color. This method is advantageous as it requires only a single staining step, making it less complex and more rapid compared to other detection techniques.

1. Indications

The CPT® Code 87271 is indicated for the detection of cytomegalovirus (CMV) in various clinical scenarios, particularly in patients who may exhibit symptoms or conditions associated with CMV infection. The following are specific indications for performing this test:

Immunocompromised Patients Individuals with weakened immune systems, such as those undergoing chemotherapy, organ transplant recipients, or individuals with HIV/AIDS, are at a higher risk for severe CMV infections and may require testing to confirm the presence of the virus.
Congenital Infection Screening Pregnant women or newborns may be tested for CMV to assess the risk of congenital CMV infection, which can lead to serious health issues in infants.
Symptoms of CMV Infection Patients presenting with symptoms such as fever, sore throat, fatigue, lymphadenopathy, or hepatosplenomegaly may be tested to determine if CMV is the causative agent of their condition.

2. Procedure

The procedure for CPT® Code 87271 involves several key steps to ensure accurate detection of cytomegalovirus antigens. The following outlines the procedural steps:

Sample Collection A sample of blood or other body fluid is collected from the patient. This sample serves as the basis for the subsequent testing process.
Inoculation with Antibodies The collected sample is then inoculated with antibodies that are specifically conjugated to fluorescein isothiocyanate. These antibodies are designed to bind to CMV antigens if they are present in the sample.
Microscopic Examination The inoculated sample is examined using an epifluorescence microscope. This specialized equipment allows for the visualization of the fluorescently labeled antibodies binding to the CMV antigens.
Interpretation of Results If CMV antigens are present, the antibodies will attach to them, resulting in a bright green staining of the nuclei of infected cells. In contrast, non-infected surrounding cells will stain a dull red, allowing for clear differentiation between infected and non-infected cells.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 87271, the laboratory will analyze the results and provide a report indicating the presence or absence of cytomegalovirus antigens in the sample. Depending on the findings, further clinical evaluation or treatment may be warranted, especially for immunocompromised patients or those with suspected congenital infections. It is essential for healthcare providers to interpret the results in conjunction with the patient's clinical history and symptoms to determine the appropriate course of action. Additionally, no specific post-procedure care is required for the patient following the test, as it is a non-invasive laboratory procedure.

Short Descr	CYTOMEGALOVIRUS DFA
Medium Descr	IAADI CYTOMEGALOVIRUS DIR FLUORESCENT ANTIBODY
Long Descr	Infectious agent antigen detection by immunofluorescent technique; Cytomegalovirus, direct fluorescent antibody (DFA)
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)