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The CPT® Code 87507 refers to the detection of infectious agents through nucleic acid analysis, specifically targeting gastrointestinal pathogens. These pathogens, which include bacteria, viruses, and parasites, are known to cause diarrheal diseases, a significant health concern that leads to malnutrition in children under five years old and ranks as the second leading cause of mortality globally. The procedure involves the simultaneous qualitative detection of various pathogens from fecal specimens collected from patients exhibiting symptoms of infectious colitis or gastroenteritis. During the testing process, the fecal sample is introduced into a culture medium where the nucleic acids, both DNA and RNA, are amplified using techniques such as polymerase chain reaction (PCR) or reverse transcription. Advanced technologies, such as the Luminex xTAG system, are employed to analyze the sample, determining the presence or absence of each targeted pathogen. The pathogens identified can include multiple types and subtypes, such as Clostridium difficile, Escherichia coli, Campylobacter, Salmonella, Shigella, norovirus, Rotavirus, Giardia, and Cryptosporidium. This code is specifically designated for panels that detect between 12 to 25 pathogenic targets, distinguishing it from other related codes that cover fewer targets.
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The CPT® Code 87507 is indicated for use in patients who present with signs and symptoms of infectious colitis or gastroenteritis. The following conditions may warrant the use of this procedure:
The procedure for CPT® Code 87507 involves several critical steps to ensure accurate detection of gastrointestinal pathogens:
After the procedure, the results are typically available within a specified timeframe, allowing for timely diagnosis and treatment. It is essential for healthcare providers to review the results in conjunction with the patient's clinical presentation to determine the appropriate course of action. Follow-up care may include additional testing or treatment based on the identified pathogens and the patient's overall health status. Proper documentation of the findings and any subsequent actions taken is crucial for compliance and reimbursement purposes.
| Short Descr | IADNA-DNA/RNA PROBE TQ 12-25 | Medium Descr | IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12-25 | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 12-25 targets | 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 |
| GA | Waiver of liability statement issued as required by payer policy, individual case | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | 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. | GW | Service not related to the hospice patient's terminal condition | Q4 | Service for ordering/referring physician qualifies as a service exemption | 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 | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | QW | Clia waived test | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2015-01-01 | Added | Added |
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