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The CPT® Code 87581 refers to a laboratory test designed for the detection of the infectious agent Mycoplasma pneumoniae through the use of nucleic acid amplification techniques, specifically targeting DNA or RNA. Mycoplasma pneumoniae is classified as an atypical bacterium that is primarily transmitted via respiratory droplets. It is known to cause mild, self-limiting upper respiratory illnesses, which can manifest as pharyngitis, tracheobronchitis, or pneumonia, particularly in children and young adults. The test utilizes an amplified probe technique, which significantly enhances the sensitivity of the assay by exponentially increasing the amount of target nucleic acid 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 Mycoplasma pneumoniae. This process allows for precise identification of the organism in respiratory or other fluid samples, thereby facilitating accurate diagnosis and management of infections caused by this pathogen.
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The procedure associated with CPT® Code 87581 is indicated for the detection of Mycoplasma pneumoniae in patients presenting with respiratory symptoms. The following conditions may warrant the use of this test:
The procedure for CPT® Code 87581 involves several critical steps to ensure accurate detection of Mycoplasma pneumoniae. The following outlines the procedural steps:
After the completion of the procedure associated with CPT® Code 87581, the laboratory will analyze the results and generate a report detailing the presence or absence of Mycoplasma pneumoniae in the sample. The results may provide quantitative data regarding the amount of nucleic acid detected, which can assist healthcare providers in assessing the severity of the infection. It is important for healthcare professionals to interpret the results in conjunction with clinical findings and other diagnostic tests. Follow-up care may be necessary based on the results, including potential treatment options for the patient.
| Short Descr | M.PNEUMON DNA AMP PROBE | Medium Descr | IADNA MYCOPLSM PNEUMONIAE AMPLIFIED PROBE TQ | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, 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. | CR | Catastrophe/disaster related | 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 | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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. | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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) | 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 | QW | Clia waived test | RT | Right side (used to identify procedures performed on the right side of the body) | SA | Nurse practitioner rendering service in collaboration with a physician | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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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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