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The CPT® Code 87486 refers to a laboratory test designed to detect the infectious agent Chlamydia pneumoniae through the use of nucleic acid detection techniques, specifically targeting DNA or RNA. Chlamydia pneumoniae is classified as an atypical bacterium that is transmitted from person to person via respiratory secretions. Infections caused by this organism can manifest in various respiratory conditions, including pneumonia, bronchitis, pharyngitis, laryngitis, and sinusitis. The test utilizes an amplified probe technique, which significantly enhances the sensitivity of the assay by exponentially increasing the amount of target nucleic acid present in the sample. This is achieved through methods such as polymerase chain reaction (PCR) or reverse transcriptase polymerase chain reaction (RT-PCR), which replicate the target DNA or RNA sequences into millions of copies. The amplified sequences are then identified using labeled probes that specifically bind to the target nucleic acid sequence. This process allows for a more accurate detection of Chlamydia pneumoniae in respiratory samples, facilitating timely diagnosis and treatment of infections associated with this pathogen.
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The procedure associated with CPT® Code 87486 is indicated for the detection of Chlamydia pneumoniae in patients presenting with respiratory symptoms. The following conditions may warrant the use of this test:
The procedure for detecting Chlamydia pneumoniae using CPT® Code 87486 involves several critical steps to ensure accurate results. The first step is the collection of a respiratory secretion sample from the patient, which may include sputum, throat swabs, or nasal aspirates. Once the sample is obtained, it is treated to release the nucleic acids from any present Chlamydia pneumoniae organisms. This treatment is essential as it prepares the sample for the subsequent amplification process. Following this, the amplified probe technique is employed, where the target nucleic acid sequence of Chlamydia pneumoniae is exponentially multiplied. This amplification is typically achieved through polymerase chain reaction (PCR) or reverse transcriptase polymerase chain reaction (RT-PCR), which allows for the creation of millions of copies of the target sequence. After amplification, labeled DNA probes are introduced to the sample. These probes are designed to specifically bind to the target nucleic acid sequence, forming stable hybrids. The presence of these hybrids indicates the presence of Chlamydia pneumoniae in the sample, thus confirming the infection.
After the completion of the nucleic acid detection procedure, the laboratory will analyze the results to determine the presence of Chlamydia pneumoniae. The results are typically reported back to the healthcare provider, who will interpret the findings in the context of the patient's clinical presentation. If the test is positive, appropriate treatment options will be discussed with the patient. It is important for healthcare providers to consider the patient's symptoms and medical history when determining the next steps in management. Additionally, follow-up care may be necessary to monitor the patient's response to treatment and to ensure resolution of the infection.
| Short Descr | CHLMYD PNEUM DNA AMP PROBE | Medium Descr | IADNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE TQ | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, 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) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 206 - Microscopic examination (bacterial smear, culture, toxicology) |
| 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. | 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. | GW | Service not related to the hospice patient's terminal condition | CR | Catastrophe/disaster related | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main 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. | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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. | GZ | Item or service expected to be denied as not reasonable and necessary | 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 | SA | Nurse practitioner rendering service in collaboration with a physician |
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| 2022-01-01 | Changed | Short description changed. |
| 2011-01-01 | Changed | Short description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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