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The CPT® Code 87468 refers to a laboratory test specifically designed for the detection of the infectious agent Anaplasma phagocytophilum through nucleic acid analysis, which can involve either DNA or RNA. Anaplasma phagocytophilum is a gram-negative bacterium that is transmitted to humans primarily through tick bites, leading to a condition known as human granulocytic anaplasmosis. This illness is characterized by symptoms such as fever, chills, malaise, muscle aches, and headache. The detection of Anaplasma phagocytophilum is achieved using advanced molecular techniques, particularly polymerase chain reaction (PCR) methods. These methods amplify the nucleic acid present in the sample, allowing for the identification of the pathogen even in small quantities. The most commonly utilized techniques include real-time polymerase chain reaction (qPCR) and reverse transcription polymerase chain reaction (RT-PCR) for RNA detection. In the case of RNA, the sample is first converted into complementary DNA (cDNA) using reverse transcriptase. The subsequent steps involve the amplification of the DNA target sequence, which is facilitated by the use of specific primers, polymerase enzymes, and fluorescent dyes or probes. This amplification process is repeated multiple times, resulting in millions of copies of the target DNA, which can then be quantified. The use of fluorescent or chemiluminescent labels in real-time PCR allows for the simultaneous detection of the amplified sequences, providing valuable information regarding the presence and quantity of the infectious agent in the patient's blood sample.
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The procedure associated with CPT® Code 87468 is indicated for the detection of the infectious agent Anaplasma phagocytophilum in patients who may be exhibiting symptoms consistent with human granulocytic anaplasmosis. The following conditions warrant the performance of this test:
The procedure for detecting Anaplasma phagocytophilum using CPT® Code 87468 involves several critical steps that ensure accurate identification of the pathogen's nucleic acid. The following procedural steps are outlined:
After the completion of the nucleic acid detection procedure, the patient may not require any specific post-procedure care related to the test itself. However, it is essential for healthcare providers to review the results promptly and discuss them with the patient. If Anaplasma phagocytophilum is detected, appropriate treatment options should be considered based on the patient's clinical presentation and overall health status. Follow-up appointments may be necessary to monitor the patient's response to treatment and to address any ongoing symptoms or concerns related to the infection.
| Short Descr | ANAPLSMA PHGCYTOPHLM AMP PRB | Medium Descr | IADNA ANAPLASMA PHAGOCYTOPHILUM AMPLIFED PRB TQ | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); Anaplasma phagocytophilum, amplified probe technique | 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) | none | MUE | 1 |
| 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. | 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. | 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 | 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 | 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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| 2023-01-01 | Added | Code added. |
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