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The CPT® Code 87502 refers to a diagnostic test that detects the presence of influenza virus by analyzing nucleic acids, specifically DNA or RNA. This test is designed to identify multiple types or sub-types of the influenza virus, which are critical for determining the specific strain affecting a patient. Influenza viruses are categorized primarily into two main types: type A and type B. Within these categories, there are various subtypes, such as H1N1, H3N2, and H5N1, which can have significant implications for treatment and public health. The process of nucleic acid detection involves extracting genetic material from a laboratory specimen, which may include blood or other bodily fluids. The test utilizes a technique known as multiplex reverse transcription, which, when performed, allows for the simultaneous detection of multiple influenza strains. Additionally, the multiplex amplified probe technique is employed to enhance the sensitivity and specificity of the test. This method involves amplifying the extracted DNA or RNA to facilitate the identification of specific influenza types or subtypes. For coding purposes, CPT® Code 87502 is used for multiplex testing of the first two types or subtypes of influenza, while separate codes are designated for single types or additional subtypes, ensuring accurate billing and documentation in medical coding practices.
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The CPT® Code 87502 is indicated for the detection of influenza virus in patients presenting with symptoms consistent with influenza infection. The test is particularly useful in the following scenarios:
The procedure for CPT® Code 87502 involves several key steps to ensure accurate detection of the influenza virus:
After the completion of the testing procedure associated with CPT® Code 87502, the results are typically available within a short timeframe, allowing for timely clinical decision-making. Healthcare providers should review the test results in conjunction with the patient's clinical presentation and history. Depending on the findings, appropriate antiviral treatments may be initiated, especially in high-risk patients. Additionally, public health measures may be considered if the test indicates a significant presence of a particular influenza strain. It is also important for healthcare providers to document the test results and any subsequent actions taken in the patient's medical record to ensure continuity of care and compliance with reporting requirements.
| Short Descr | INFLUENZA DNA AMP PROBE | Medium Descr | INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, first 2 types or sub-types | 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) | Yes | 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) |
This is a primary code that can be used with these additional add-on codes.
| 87503 | Addon Code MPFS Status: Statutory exclusion (from MPFS, may be paid under other methodologies) APC Q4 Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, each additional influenza virus type or sub-type beyond 2 (List separately in addition to code for primary procedure) |
| QW | Clia waived test | 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 | 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. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GC | This service has been performed in part by a resident under the direction of a teaching physician | GA | Waiver of liability statement issued as required by payer policy, individual case | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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. | SA | Nurse practitioner rendering service in collaboration with a physician | 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 | 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. | 93 | Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | CS | Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency | ER | Items and services furnished by a provider-based, off-campus emergency department | KX | Requirements specified in the medical policy have been met | PA | Surgical or other invasive procedure on wrong body part | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q2 | Demonstration procedure/service | 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 | QN | Ambulance service furnished directly by a provider of services | RT | Right side (used to identify procedures performed on the right side of the body) | U6 | Medicaid level of care 6, as defined by each state | UA | Medicaid level of care 10, as defined by each state | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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| 2016-01-01 | Changed | Description Changed |
| 2015-01-01 | Changed | Description Changed |
| 2012-01-01 | Changed | Code description changed. |
| 2011-04-01 | Changed | Added term "multiplex" to the description per CPT corrections notice. |
| 2011-01-01 | Added | Added |
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