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The CPT® Code 87469 refers to a laboratory test specifically designed for the detection of the infectious agent Babesia microti through the use of nucleic acid amplification techniques, which can involve either DNA or RNA. Babesia microti is a protozoan parasite that primarily infects human red blood cells, typically transmitted via the bite of an infected tick. This parasite is responsible for causing babesiosis, a disease that presents symptoms similar to malaria, including fever and hemolysis. In addition to tick bites, babesiosis can also be transmitted through infected blood transfusions, making accurate detection crucial for patient management and treatment. The test utilizes advanced molecular techniques, such as polymerase chain reaction (PCR), to amplify the genetic material of the parasite, allowing for its identification even in small quantities. The amplification process involves converting RNA to complementary DNA (cDNA) using reverse transcriptase, followed by a series of heating and cooling cycles that facilitate the replication of the target DNA sequence. This method not only enhances the sensitivity of the test but also enables real-time monitoring of the amplification process through fluorescent or chemiluminescent probes, providing quantitative data on the presence of Babesia microti in the sample. The results generated from this test are critical for diagnosing babesiosis and guiding appropriate clinical interventions.
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The CPT® Code 87469 is indicated for the detection of Babesia microti in patients who may be experiencing symptoms associated with babesiosis or who have a known exposure to infected ticks or blood products. The following conditions warrant the use of this test:
The procedure for detecting Babesia microti using CPT® Code 87469 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 procedure associated with CPT® Code 87469, the laboratory will analyze the results and generate a report detailing the presence or absence of Babesia microti nucleic acid in the sample. Clinicians will review these results to make informed decisions regarding patient management and treatment options. It is important for healthcare providers to communicate the results to the patient and discuss any necessary follow-up actions, which may include further testing or initiation of treatment for babesiosis if the test is positive. Additionally, proper documentation of the test results and any subsequent clinical actions taken is essential for maintaining accurate medical records and ensuring continuity of care.
| Short Descr | BABESIA MICROTI AMP PRB | Medium Descr | IADNA BABESIA MICROTI AMPLIFIED PROBE TECHNIQUE | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); Babesia microti, 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 | GW | Service not related to the hospice patient's terminal condition | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2023-01-01 | Added | Code added. |
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