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Official Description

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; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19])

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 87426 refers to a laboratory test designed to detect the presence of severe acute respiratory syndrome coronavirus (SARS-CoV) and its variant SARS-CoV-2, which is responsible for COVID-19. This detection is achieved through various immunoassay techniques, including enzyme immunoassay (EIA), enzyme-linked immunosorbent assay (ELISA), fluorescence immunoassay (FIA), and immunochemiluminometric assay (IMCA). These methods are utilized to identify the antigen associated with the virus in a sample, typically obtained from respiratory secretions. The test can provide qualitative results, indicating whether the antigen is present, or semi-quantitative results, which can give an estimate of the amount of antigen detected. COVID-19 manifests with a range of symptoms, including cough, fever, chills, shortness of breath, dyspnea, chest pain, muscle aches, and fatigue. While many individuals experience mild to moderate symptoms and recover without the need for specialized treatment, severe cases can lead to significant respiratory distress, necessitating hospitalization and potentially ventilator support. Certain populations, particularly older adults and individuals with pre-existing health conditions such as heart or lung disease, cancer, or diabetes, are at an increased risk for severe illness. The testing process involves collecting a sample of respiratory secretions, which is then either placed in a fixative or sent fresh to a laboratory for analysis. The immunoassay techniques employed in this test work by detecting the antigen when it binds to a specific antibody. In the case of EIA and ELISA, a secondary enzyme-labeled antibody is introduced, which facilitates the detection of the antigen-antibody complex through a chromogenic reaction that results in a visible color change or fluorescence. The FIA method utilizes a fluorescent compound to detect the binding of the detection antibody to the analyte, while IMCA employs antibodies labeled with a chemiluminescent substance to quantify the antigen-antibody complex based on light emission. This comprehensive approach allows for effective identification of the SARS-CoV and SARS-CoV-2 antigens, aiding in the diagnosis and management of COVID-19.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The CPT® Code 87426 is indicated for the detection of severe acute respiratory syndrome coronavirus (SARS-CoV) and SARS-CoV-2, the virus responsible for COVID-19. The test is performed in the following scenarios:

  • COVID-19 Diagnosis The test is utilized to confirm the presence of SARS-CoV or SARS-CoV-2 in individuals exhibiting symptoms consistent with COVID-19, such as cough, fever, chills, shortness of breath, dyspnea, chest pain, muscle aches, and fatigue.
  • Screening The test may be used for screening purposes in populations at risk for COVID-19, particularly in settings such as hospitals, clinics, and community health programs.
  • Monitoring The test can assist in monitoring the presence of the virus in individuals who have been exposed or are undergoing treatment for COVID-19.

2. Procedure

The procedure for conducting the test under CPT® Code 87426 involves several key steps:

  • Sample Collection A sample of respiratory secretions is collected from the patient. This may involve swabbing the nasopharynx or oropharynx, or collecting sputum, depending on the clinical scenario and the specific testing protocol.
  • Sample Preparation The collected sample is either placed in a fixative to preserve the integrity of the antigen or sent fresh to the laboratory for immediate processing. Proper handling of the sample is crucial to ensure accurate test results.
  • Immunoassay Technique Application The laboratory technician employs one of the immunoassay techniques—EIA, ELISA, FIA, or IMCA—to detect the SARS-CoV or SARS-CoV-2 antigen. This involves adding specific antibodies to the sample that will bind to the viral antigen if present.
  • Detection and Analysis In the case of EIA and ELISA, a secondary enzyme-labeled antibody is introduced, which reacts to produce a color change or fluorescence, indicating the presence of the antigen. For FIA, a fluorescent compound is used to visualize the binding of the detection antibody. IMCA utilizes a chemiluminescent substance to quantify the antigen-antibody complex based on emitted light.
  • Result Interpretation The results are assessed qualitatively or semi-quantitatively based on the intensity of the color change or fluorescence, providing information on the presence and amount of the viral antigen in the sample.

3. Post-Procedure

After the procedure, the laboratory will analyze the results and report them to the healthcare provider. The interpretation of the test results will guide clinical decision-making regarding the management of the patient. If the test is positive, appropriate isolation measures and treatment protocols for COVID-19 should be initiated. In cases of negative results, further clinical evaluation may be necessary, especially if the patient continues to exhibit symptoms. It is important for healthcare providers to communicate the results to the patient and discuss any further steps that may be required based on the findings.

Short Descr SARSCOV CORONAVIRUS AG IA
Medium Descr IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS
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; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19])
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) Yes
APC Status Indicator Service Paid under Fee Schedule or Payment System other than OPPS
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) none
MUE 1
QW Clia waived test
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.
GW Service not related to the hospice patient's terminal condition
GA Waiver of liability statement issued as required by payer policy, individual case
CR Catastrophe/disaster related
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
X1 Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care
CS Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency
Q4 Service for ordering/referring physician qualifies as a service exemption
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
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.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
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
GZ Item or service expected to be denied as not reasonable and necessary
UH Services provided in the evening
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
32 Mandated services: services related to mandated consultation and/or related services (eg, third party payer, governmental, legislative or regulatory requirement) may be identified by adding modifier 32 to the basic procedure.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
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.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
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.
93 Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AO Alternate payment method declined by provider of 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)
CG Policy criteria applied
GT Via interactive audio and video telecommunication systems
KX Requirements specified in the medical policy have been met
LT Left side (used to identify procedures performed on the left side of the body)
PA Surgical or other invasive procedure on wrong body part
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q3 Live kidney donor surgery and related services
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
QJ Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
QP Documentation is on file showing that the laboratory test(s) was ordered individually or ordered as a cpt-recognized panel other than automated profile codes 80002-80019, g0058, g0059, and g0060.
SA Nurse practitioner rendering service in collaboration with a physician
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
U6 Medicaid level of care 6, as defined by each state
U7 Medicaid level of care 7, as defined by each state
UC Medicaid level of care 12, as defined by each state
UD Medicaid level of care 13, as defined by each state
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
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
Date
Action
Notes
2022-01-01 Changed First appearance of change in codebook.
2022-01-01 Note Grammatical correction.
2021-01-01 Added First appearance of code in CPT® Code Set.
2021-01-01 Changed First appearance of change in CPT® Code Set.
2020-10-06 Changed Code description changed.
2020-06-25 Added Code added.
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Description
Code
Description
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