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The CPT® Code 87385 refers to a laboratory test designed to detect the presence of the antigen associated with Histoplasma capsulatum, a pathogenic fungus commonly found in environments rich in bat or bird droppings. This test employs various immunoassay techniques, including enzyme immunoassay (EIA), enzyme-linked immunosorbent assay (ELISA), fluorescence immunoassay (FIA), and immunochemiluminometric assay (IMCA). These methodologies are crucial for identifying the antigen in biological samples, which may include blood or respiratory secretions. The detection of Histoplasma capsulatum is particularly significant as exposure to its spores can lead to a range of health issues, from mild respiratory symptoms such as cough, fever, and fatigue to more severe systemic infections, especially in individuals with weakened immune systems. The test is performed by obtaining a sample that is either preserved in a fixative or sent fresh to the laboratory for analysis. The immunoassay techniques utilized in this test are adept at identifying even minute quantities of the antigen by employing specific antibodies that bind to the antigen, followed by a secondary detection method that produces a measurable signal, such as a color change or fluorescence. This allows for both qualitative and semi-quantitative assessments of the antigen's presence in the sample.
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The CPT® Code 87385 is indicated for the detection of Histoplasma capsulatum antigen in patients who may be exhibiting symptoms or conditions associated with histoplasmosis. The following are specific indications for performing this test:
The procedure for conducting the test under CPT® Code 87385 involves several key steps to ensure accurate detection of the Histoplasma capsulatum antigen. The following procedural steps are outlined:
After the completion of the test, the laboratory will analyze the results and report the findings. The expected outcome is a qualitative or semi-quantitative measure of the Histoplasma capsulatum antigen in the sample. Clinicians will interpret these results in conjunction with the patient's clinical presentation and history. It is important for healthcare providers to follow up with patients regarding their results and any necessary further actions or treatments based on the findings of the test.
| Short Descr | HISTOPLASMA CAPSUL AG IA | Medium Descr | IAAD IA HISTOPLASM CAPSULATUM | Long Descr | Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; Histoplasma capsulatum | 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 | 2 | 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. | 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | 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. | 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. | 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. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | G8 | Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure | 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 | Q4 | Service for ordering/referring physician qualifies as a service exemption | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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Notes
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| 2022-01-01 | Changed | First appearance of change in codebook. |
| 2022-01-01 | Note | Grammatical correction. |
| 2021-01-01 | Changed | First appearance of change in CPT® Code Set. |
| 2020-10-06 | Changed | Code changed. |
| 2016-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Changed | Code description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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