CPT® Code 87470

Official Description

Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, direct probe technique

Common Language Description

The CPT® Code 87470 refers to a laboratory test designed for the detection of specific infectious agents, namely Bartonella henselae and Bartonella quintana, through the use of nucleic acid techniques, specifically targeting DNA or RNA. Bartonella is classified as a small, gram-negative bacillus that poses challenges in terms of isolation and culture in laboratory settings. The significance of this test lies in its ability to identify the presence of these pathogens rapidly, circumventing the traditional culture methods that can be time-consuming and less effective. The direct probe technique employed in this test utilizes nucleic acid probes that are specifically designed to bind to unique sequences of the Bartonella species' genetic material, known as the target sequence. This binding occurs if the target sequence is present in the sample being tested. The probes used in this process are labeled with either fluorescent or chemiluminescent markers, which facilitate the detection of the hybridized sequences. The procedure involves treating the sample to release nucleic acids from the target organism, allowing the labeled probe to form a stable hybrid with the target sequence. Ribosomal RNA is often the focus of these tests due to its abundance in microorganisms, making it a reliable target for detection. This method is particularly important for diagnosing conditions associated with these pathogens, such as cat scratch disease caused by B. henselae, which can lead to serious disseminated infections, and trench fever or bacillary angiomatosis associated with B. quintana, especially in immunocompromised individuals such as those with HIV. Overall, the use of nucleic acid detection techniques represents a significant advancement in the rapid identification of these infectious agents, enhancing diagnostic capabilities in clinical laboratories.

1. Indications

The CPT® Code 87470 is indicated for the detection of specific infectious agents, particularly in the following conditions:

Cat Scratch Disease (CSD) - This condition is primarily caused by Bartonella henselae, which can lead to severe disseminated infections in some patients.
Trench Fever - Associated with Bartonella quintana, this condition can occur in individuals with a history of exposure to lice or in certain populations, such as the homeless.
Bacillary Angiomatosis - This is a condition seen in immunocompromised patients, particularly those with HIV, and is linked to Bartonella quintana.

2. Procedure

The procedure for CPT® Code 87470 involves several critical steps to ensure accurate detection of the target infectious agents:

Sample Collection - A biological sample, such as blood or tissue, is collected from the patient, which may contain the nucleic acids of the target organisms.
Nucleic Acid Extraction - The collected sample undergoes treatment to release nucleic acids from any present Bartonella organisms. This step is crucial for isolating the genetic material necessary for detection.
Probe Hybridization - A labeled nucleic acid probe, specific to the target sequence of Bartonella species, is introduced to the sample. The probe binds to the complementary nucleic acid sequence if the target is present, forming a stable hybrid.
Detection of Hybridization - The hybridized probe is then detected using fluorescent or chemiluminescent methods, allowing for the identification of the presence of Bartonella DNA or RNA in the sample.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 87470, the laboratory will analyze the results to determine the presence of the target nucleic acids. The findings will be documented in a report, which will indicate whether Bartonella henselae or Bartonella quintana was detected in the sample. Clinicians will use this information to guide further diagnostic and therapeutic decisions. There are typically no specific post-procedure care requirements for patients, as the procedure is performed in a laboratory setting and does not involve invasive techniques. However, clinicians may monitor patients for symptoms related to the infections associated with these pathogens, especially in cases where a positive result is obtained.

Short Descr	BARTONELLA DNA DIR PROBE
Medium Descr	IADNA BARTONELLA DIRECT PROBE TECHNIQUE
Long Descr	Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, direct 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
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	Not applicable/unspecified.
CCS Clinical Classification	206 - Microscopic examination (bacterial smear, culture, toxicology)