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The CPT® Code 87563 refers to a laboratory test designed for the detection of the infectious agent Mycoplasma genitalium (M. genitalium) through nucleic acid amplification techniques. M. genitalium is a small, gram-negative bacterium that resides in the epithelial cells of the male and female genital tracts. This organism is known to cause various inflammatory conditions, including urethritis in males and cervicitis in females, and has been implicated in female pelvic inflammatory disease (PID). The test involves the collection of a specimen, which can be obtained from the penile urethra, endo-cervix, or vagina, using a swab. Additionally, patients have the option to self-collect specimens from the penile meatus or first catch urine, applicable to both males and females. Once the specimen is collected, it is placed into a specialized transport tube that contains target ribonucleic acid (rRNA). This setup is crucial for isolating M. genitalium, if present, through a process that utilizes a capture oligomer and magnetic microparticles. The specimen undergoes hybridization, allowing the capture oligomer to bind to the target rRNA, forming a complex that can be extracted via covalent attachment to the magnetic particles. Following this, the rRNA is amplified in specific regions, and a single-stranded, chemiluminescent-labeled complementary DNA probe is introduced, resulting in the formation of a DNA/RNA hybrid. The emitted light from this hybrid can be quantified as a photon signal using an illuminator reading device, providing a reliable means of detecting the presence of M. genitalium in the collected specimen.
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The CPT® Code 87563 is indicated for the detection of Mycoplasma genitalium in patients presenting with specific symptoms or conditions related to genital tract infections. The following indications are explicitly associated with this procedure:
The procedure for detecting Mycoplasma genitalium using CPT® Code 87563 involves several critical steps, each designed to ensure accurate identification of the bacterium. The following procedural steps are outlined:
After the completion of the procedure associated with CPT® Code 87563, the laboratory will analyze the emitted signals to determine the presence of Mycoplasma genitalium. Results are typically reported to the requesting clinician, who will interpret the findings in the context of the patient's clinical presentation. It is essential for healthcare providers to follow up with patients regarding their results and any necessary treatment options based on the findings. Additionally, proper documentation of the procedure and results is crucial for compliance and billing purposes.
| Short Descr | M. GENITALIUM AMP PROBE | Medium Descr | IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, 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) | none | MUE | 3 |
| 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | 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. | 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 | GF | Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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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| 2020-01-01 | Added | Code added. |
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