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The CPT® Code 87637 refers to a diagnostic procedure that utilizes a multiplex amplified probe technique for the detection of specific infectious agents, namely severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus types A and B, and respiratory syncytial virus (RSV). This advanced testing method is particularly significant in the context of respiratory illnesses, as it allows for the simultaneous identification of multiple viruses from a single patient sample. The procedure is designed to detect even minute quantities of viral genetic material, which is crucial for accurate diagnosis, especially when the presence of the virus is low. The process begins with the collection of a respiratory sample, which can be obtained through various methods such as swabbing the nose or throat, or through more invasive techniques like bronchoalveolar lavage. Once the sample is collected, it undergoes a series of chemical treatments to isolate the RNA, which is then reverse transcribed into DNA, as the amplification process requires DNA. The use of oligonucleotide probes and primers, which are tagged with fluorescent markers, allows for the specific targeting and amplification of the viral DNA. This amplification is achieved through a series of cycles in a real-time reverse transcription-polymerase chain reaction (RT-PCR) machine, where the amount of DNA doubles with each cycle. The fluorescent markers provide real-time feedback on the amplification process, enabling the detection of the virus when a certain fluorescence threshold is reached. This method not only confirms the presence of the virus but also aids in assessing the severity of the disease based on the number of cycles required to achieve this confirmation. Overall, this procedure plays a critical role in the management of respiratory illnesses, guiding treatment decisions and public health measures.
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The CPT® Code 87637 is indicated for the detection of specific viral infections in patients presenting with respiratory symptoms. The following conditions warrant the use of this multiplex amplified probe technique:
The procedure for CPT® Code 87637 involves several critical steps to ensure accurate detection of the targeted viruses. The following outlines the procedural steps:
After the completion of the procedure associated with CPT® Code 87637, the results are analyzed and reported to the healthcare provider. The timely identification of the viruses allows for appropriate treatment decisions to be made, which may include antiviral medications or supportive care, depending on the diagnosis. Additionally, the results can inform public health measures, such as isolation protocols, to prevent the spread of infectious diseases. Patients may be monitored for symptoms and provided with guidance on follow-up care based on the test outcomes. It is essential to ensure that proper documentation of the procedure and results is maintained for compliance and billing purposes.
| Short Descr | SARSCOV2&INF A&B&RSV AMP PRB | Medium Descr | IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), influenza virus types A and B, and respiratory syncytial virus, multiplex 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 | Service Paid under Fee Schedule or Payment System other than OPPS | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| QW | Clia waived test | GW | Service not related to the hospice patient's terminal condition | 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. | 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. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | HF | Substance abuse program | 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. | 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. | 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 | 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 | 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 | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 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) | SC | Medically necessary service or supply | U7 | Medicaid level of care 7, as defined by each state | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2023-01-01 | Added | First appearance of guideline addition in codebook. |
| 2022-02-21 | Changed | Guidelines Added |
| 2022-01-01 | Added | First appearance of code in codebook. |
| 2022-01-01 | Changed | Short description changed. |
| 2022-01-01 | Note | Grammar correction |
| 2021-01-01 | Added | First appearance of code in CPT® Code Set. |
| 2020-10-06 | Added | Code added. |
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