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The CPT® Code 87634 refers to a laboratory test specifically designed for the detection of the infectious agent known as respiratory syncytial virus (RSV) through the use of nucleic acid analysis, which can involve either DNA or RNA. Respiratory syncytial virus is a prevalent respiratory pathogen that typically manifests as cold-like symptoms in adults and older children. However, it poses a significant risk to vulnerable populations, particularly infants under one year of age and the elderly, as it is a leading cause of severe lung infections and airway inflammation in these groups. The test utilizes an amplified probe technique, which enhances the sensitivity of the assay by exponentially increasing the quantity of the target RSV DNA or RNA sequence. This amplification process is most commonly achieved through methods such as polymerase chain reaction (PCR) or reverse transcriptase polymerase chain reaction (RT-PCR). Following amplification, the resultant replicated sequences are identified using DNA probes that are labeled with either fluorescent or chemiluminescent markers, ensuring that they bind specifically to the target sequence of RSV. This precise detection method is crucial for accurate diagnosis and management of RSV infections.
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The procedure associated with CPT® Code 87634 is indicated for the detection of respiratory syncytial virus (RSV) in patients who present with symptoms consistent with a respiratory infection. The following conditions may warrant the use of this test:
The procedure for detecting respiratory syncytial virus (RSV) using CPT® Code 87634 involves several key steps that ensure accurate identification of the virus's nucleic acid. The following procedural steps are typically followed:
Post-procedure care following the RSV detection test using CPT® Code 87634 typically involves monitoring the patient for any symptoms of respiratory distress or complications. The healthcare provider will review the test results and may recommend further management based on the findings. If RSV is detected, appropriate treatment options, such as supportive care or antiviral medications, may be discussed. Additionally, healthcare providers may advise on infection control measures to prevent the spread of the virus, especially in high-risk settings such as hospitals or nursing homes. Follow-up appointments may be scheduled to reassess the patient's condition and response to treatment.
| Short Descr | RSV DNA/RNA AMP PROBE | Medium Descr | IADNA DNA/RNA RSV AMPLIFIED PROBE TECHNIQUE | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); respiratory syncytial virus, 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) | Yes | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 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. | 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 | 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. | GW | Service not related to the hospice patient's terminal condition | 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. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GZ | Item or service expected to be denied as not reasonable and necessary | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | 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 | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | 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 | 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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| 2018-01-01 | Added | Code Added. |
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