CPT® Code 87281

Official Description

Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii

Common Language Description

The CPT® Code 87281 refers to a laboratory test specifically designed for the detection of the Pneumocystis carinii antigen using an immunofluorescent technique. Pneumocystis carinii, now known as Pneumocystis jirovecii, is a unicellular fungus that is particularly significant in the context of opportunistic infections, especially among individuals who are immunocompromised. This includes patients with conditions such as HIV/AIDS, various primary immune deficiencies like CD40-ligand deficiency and X-linked hyper-IgM syndrome, as well as those suffering from severe combined immunodeficiency, severe malnutrition, and organ transplant recipients. The test is typically performed on respiratory samples, which may include bronchial washings, bronchoalveolar lavage (BAL), or induced sputum. The procedure involves treating the collected sample with a detecting reagent that contains antibodies specific to Pneumocystis, along with a counterstain. The sample is then examined under an epifluorescence microscope. If Pneumocystis carinii is present in the sample, the antibodies will bind to the antigens, resulting in a distinct color change that can be observed through the microscope. This method is noted for its rapid results, although it may be less sensitive compared to other techniques such as reverse transcription-polymerase chain reaction (RT-PCR). The symptoms associated with Pneumocystis carinii infections include dyspnea, particularly during exertion, fever, chills, a non-productive cough, chest pain, weight loss, tachypnea, and tachycardia, which are critical indicators for clinicians when considering this diagnostic test.

1. Indications

The CPT® Code 87281 is indicated for use in the detection of Pneumocystis carinii antigen in patients who are at risk for opportunistic infections due to compromised immune systems. The following conditions and symptoms warrant the performance of this test:

HIV/AIDS Patients with HIV/AIDS are at a significantly increased risk for Pneumocystis carinii infections due to their weakened immune response.
Primary Immune Deficiencies Conditions such as CD40-ligand deficiency and X-linked hyper-IgM syndrome can lead to increased susceptibility to infections, including those caused by Pneumocystis carinii.
Severe Combined Immunodeficiency Individuals with severe combined immunodeficiency (SCID) lack functional immune responses, making them vulnerable to opportunistic infections.
Severe Malnutrition Malnutrition can impair immune function, increasing the risk of infections, including those caused by Pneumocystis carinii.
Transplant Recipients Patients who have undergone organ transplants often require immunosuppressive therapy, which can predispose them to opportunistic infections.
Respiratory Symptoms Symptoms such as dyspnea, especially with exertion, fever, chills, non-productive cough, chest pain, weight loss, tachypnea, and tachycardia may indicate a Pneumocystis carinii infection and necessitate testing.

2. Procedure

The procedure for CPT® Code 87281 involves several critical steps to ensure accurate detection of Pneumocystis carinii antigen. First, a respiratory sample is obtained from the patient. This sample may be collected through bronchial washing, bronchoalveolar lavage (BAL), or induced sputum, depending on the clinical scenario and the patient's condition. Once the sample is collected, it is treated with a detecting reagent that contains specific antibodies against Pneumocystis carinii, along with a counterstain to enhance visualization. After the treatment, the sample is placed under an epifluorescence microscope for examination. During this phase, the technician looks for a distinct color change that indicates the presence of Pneumocystis carinii antigens. If the antigens are present, the antibodies in the detecting reagent will bind to them, resulting in a visible reaction that can be observed through the microscope. This immunofluorescent technique allows for rapid results, although it is important to note that it may be less sensitive than other molecular methods such as reverse transcription-polymerase chain reaction (RT-PCR).

3. Post-Procedure

After the procedure associated with CPT® Code 87281, the patient may not require any specific post-procedure care related to the test itself, as it is a non-invasive laboratory procedure. However, clinicians should monitor the patient for any signs of respiratory distress or complications related to their underlying condition. The results of the test will be interpreted in conjunction with the patient's clinical symptoms and history. If Pneumocystis carinii is detected, appropriate treatment options will be considered based on the patient's overall health status and specific clinical guidelines. Follow-up care may include further diagnostic testing or adjustments to the patient's treatment regimen to address any identified infections.

Short Descr	PNEUMOCYSTIS CARINII AG IF
Medium Descr	IAADI PNEUMOCUSTIS CARINII
Long Descr	Infectious agent antigen detection by immunofluorescent technique; Pneumocystis carinii
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)

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.
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.