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The CPT® Code 87631 refers to a diagnostic test that detects infectious agents through the analysis of nucleic acids, specifically DNA or RNA, in respiratory specimens. This test is crucial for identifying various respiratory viruses, which may include adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus (RSV), and rhinovirus. The procedure involves obtaining a respiratory specimen through methods such as bronchoalveolar lavage, nasal wash, nasopharyngeal swab, or pleural fluid aspiration. Once the specimen is collected, it undergoes a sophisticated testing process that utilizes multiplex reverse transcription polymerase chain reaction (RT-PCR). This technique allows for the extraction and amplification of DNA or RNA from multiple types or subtypes of the targeted respiratory viruses. The amplified nucleic acid fragments are then sized and analyzed to determine the specific types or subtypes present in the specimen. This code is specifically designated for tests that target 3 to 5 different types or subtypes of respiratory viruses, providing healthcare professionals with essential information for diagnosis and treatment planning.
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The CPT® Code 87631 is indicated for the detection of specific respiratory viral infections. The following conditions or symptoms may warrant the use of this test:
The procedure for CPT® Code 87631 involves several critical steps to ensure accurate detection of respiratory viruses. The following outlines the procedural steps:
Post-procedure care for patients undergoing testing with CPT® Code 87631 typically involves monitoring for any immediate adverse reactions related to the specimen collection method used. Patients may be advised to follow up with their healthcare provider to discuss the test results and any necessary treatment options based on the identified viral pathogens. Additionally, healthcare professionals should ensure that proper documentation of the procedure and results is maintained for compliance and billing purposes.
| Short Descr | RESP VIRUS 3-5 TARGETS | Medium Descr | IADNA RESPIRATRY PROBE & REV TRNSCR 3-5 TARGETS | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 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) | 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) |
| 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 | 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. | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GA | Waiver of liability statement issued as required by payer policy, individual case | 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. | 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. | 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. | 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) | 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 | GC | This service has been performed in part by a resident under the direction of a teaching physician | GT | Via interactive audio and video telecommunication systems | 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 | Q3 | Live kidney donor surgery and related services | 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 | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | SA | Nurse practitioner rendering service in collaboration with a physician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2015-01-01 | Changed | Description Changed |
| 2013-01-01 | Added | Added. Short descriptor changed per AMA 2013 corrections document. |
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