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The CPT® Code 87498 refers to the detection of infectious agents, specifically enteroviruses, through nucleic acid testing techniques. Enteroviruses are a group of viruses that primarily inhabit the intestinal tract and can lead to a variety of disease symptoms, ranging from mild respiratory illness to more severe conditions. The method of nucleic acid detection serves as a valuable diagnostic tool, offering an alternative to traditional culturing methods, which can be time-consuming and less sensitive. This technique allows for the identification of much lower concentrations of the infectious agent, sometimes even detecting a single organism. The process involves the extraction of the virus's nucleic acid, either DNA or RNA, from the sample. This is achieved through a method known as nucleic acid hybridization, where a laboratory-prepared probe—composed of complementary strands of nucleic acid—is utilized. These probes are often labeled with chemical fluorescence to facilitate the identification of the target nucleic acid. The binding of the probe to the target nucleic acid forms stable complexes, enabling the detection of the infectious agent. The amplified probe technique enhances sensitivity and specificity, utilizing methods such as reverse transcription polymerase chain reaction (RT-PCR) to replicate specific sequences within the nucleic acid. This enzymatic replication allows for exponential amplification of the target nucleic acid, significantly increasing the likelihood of detection. Additionally, amplification primers, which are short strands of nucleic acid complementary to the target region, are employed to ensure accurate binding and replication, further aiding in the identification of the enterovirus.
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The procedure associated with CPT® Code 87498 is indicated for the detection of enteroviruses in patients presenting with symptoms that may suggest an enteroviral infection. These symptoms can include, but are not limited to, fever, respiratory distress, gastrointestinal disturbances, and neurological manifestations. The nucleic acid detection method is particularly useful in cases where traditional culture methods may be inadequate or time-consuming, allowing for rapid diagnosis and appropriate management of the patient's condition.
The procedure for CPT® Code 87498 involves several key steps to accurately detect enteroviruses through nucleic acid testing. First, a specimen is collected from the patient, which may include stool, respiratory secretions, or other bodily fluids where the virus may be present. Once the specimen is obtained, it undergoes processing to extract the nucleic acid. This extraction is crucial as it isolates the viral RNA or DNA from the sample, allowing for subsequent analysis. Following extraction, the amplified probe technique is employed. This involves the use of specific probes that are designed to bind to the target nucleic acid sequences of the enterovirus. The probes are often labeled with fluorescent markers to facilitate detection. The next step is the reverse transcription process, which converts any viral RNA into complementary DNA (cDNA) if RNA is present. This cDNA then serves as the template for amplification. The polymerase chain reaction (PCR) is performed, where primers that are complementary to the target sequences are added. These primers bind to the cDNA, and the polymerase enzyme replicates the target sequences, leading to exponential amplification of the nucleic acid. This amplification significantly increases the sensitivity of the test, allowing for the detection of even low levels of the virus. Finally, the results are analyzed, and the presence of enterovirus nucleic acid is confirmed through the detection of the fluorescent signal, indicating a positive result.
After the completion of the nucleic acid detection procedure, the patient may not require any specific post-procedure care, as the process is non-invasive and does not typically result in complications. However, it is essential for healthcare providers to monitor the patient for any symptoms that may arise following the procedure. The results of the test are usually available within a short timeframe, allowing for timely diagnosis and treatment decisions. If the test is positive for enterovirus, appropriate clinical management should be initiated based on the patient's symptoms and overall clinical picture. In cases where the test is negative but clinical suspicion remains high, further testing or alternative diagnostic approaches may be considered to ensure accurate diagnosis and patient care.
| Short Descr | ENTEROVIRUS PROBE&REVRS TRNS | Medium Descr | IADNA ENTEROVIRUS AMPLIF PROBE & REVRSE TRNSCRIP | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified probe technique, includes reverse transcription when performed | 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) |
| 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 | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | 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. | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2014-01-01 | Changed | Description Changed |
| 2013-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Added | First appearance in code book in 2007. |
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