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The CPT® Code 87556 refers to a laboratory test designed for the detection of the infectious agent Mycobacteria tuberculosis through the use of nucleic acid amplification techniques, specifically targeting DNA or RNA. Mycobacteria tuberculosis is a gram-positive, acid-fast bacterium that is the causative agent of both latent tuberculosis infection and active tuberculosis disease. This bacterium can affect the lungs, leading to pulmonary tuberculosis, or it can disseminate to other areas of the body. Common symptoms associated with pulmonary tuberculosis include a persistent cough, chest pain, and systemic symptoms such as fatigue, weight loss, anorexia, fever, chills, and night sweats. The transmission of tuberculosis occurs primarily through respiratory secretions, making it highly contagious and potentially fatal if left untreated. The test utilizes an amplified probe technique, which significantly enhances the sensitivity of the assay by exponentially increasing the amount of target nucleic acid from the M. tuberculosis organism 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 sequences into millions of copies. The amplified nucleic acids are then detected using labeled probes that specifically bind to the unique nucleic acid sequences of M. tuberculosis. This process allows for the identification of the bacterium even in low quantities, thereby facilitating timely diagnosis and treatment of tuberculosis infections.
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The CPT® Code 87556 is indicated for the detection of Mycobacteria tuberculosis in patients who may present with symptoms or conditions associated with tuberculosis infection. The following are specific indications for performing this test:
The procedure for CPT® Code 87556 involves several critical steps to ensure accurate detection of Mycobacteria tuberculosis. The following outlines the procedural steps:
After the completion of the procedure associated with CPT® Code 87556, the laboratory will analyze the results and generate a report detailing the presence or absence of Mycobacteria tuberculosis. It is essential for healthcare providers to review the results in conjunction with clinical findings and patient history. If the test is positive, appropriate treatment protocols for tuberculosis should be initiated promptly. Additionally, follow-up testing may be necessary to monitor the patient's response to treatment and ensure the effective management of the infection. Healthcare professionals should also consider the need for contact tracing and preventive measures to control the spread of tuberculosis, especially in cases of active infection.
| Short Descr | M.TUBERCULO DNA AMP PROBE | Medium Descr | IADNA MYCOBACTERIA TUBERCULOSIS AMP PRB | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, 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) |
| 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 | 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. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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Notes
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| 2011-01-01 | Changed | Short description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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