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The CPT® Code 87280 refers to a laboratory test specifically designed for the detection of the respiratory syncytial virus (RSV) antigen using an immunofluorescent technique. This test is crucial for identifying RSV, which is known to cause significant respiratory infections, particularly in vulnerable populations such as infants, young children, the elderly, and individuals with pre-existing lung or heart conditions. The common presentation of RSV infection can range from mild upper respiratory symptoms to severe conditions like bronchiolitis and pneumonia. The test is performed on samples obtained from the nasopharynx, either through a swab or aspirate, allowing for the direct detection of the virus's antigens. The immunofluorescent technique involves treating the sample with a reagent that contains antibodies specific to RSV, which, when examined under an epifluorescence microscope, will reveal a color change if RSV antigens are present. This method is noted for its rapid results, although it may have lower sensitivity compared to more advanced techniques such as reverse transcription-polymerase chain reaction (RT-PCR). Understanding the implications of RSV infections and the utility of this test is essential for timely diagnosis and management of affected patients.
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The CPT® Code 87280 is indicated for the detection of respiratory syncytial virus (RSV) in patients presenting with symptoms consistent with respiratory infections. The following conditions and symptoms warrant the use of this test:
The procedure for conducting the test under CPT® Code 87280 involves several key steps to ensure accurate detection of RSV antigens:
After the procedure, the results of the RSV antigen detection test can be interpreted to guide clinical management. If RSV is detected, appropriate treatment and supportive care may be initiated, especially in high-risk patients. It is important to note that while this test provides rapid results, it may be less sensitive than other methods such as reverse transcription-polymerase chain reaction (RT-PCR). Therefore, clinical correlation with patient symptoms and possibly further testing may be necessary to confirm the diagnosis and determine the best course of action for the patient’s care.
| Short Descr | RESPIRATORY SYNCYTIAL AG IF | Medium Descr | IAADI RESPIRATORY SYNCTIAL VIRUS | Long Descr | Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus | 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. | 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. | 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 |
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| 2011-01-01 | Changed | Short description changed. |
| 2001-01-01 | Changed | Code description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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