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The CPT® Code 87650 refers to a laboratory test designed for the detection of the infectious agent known as Streptococcus, group A (GAS) through the use of nucleic acid techniques, specifically targeting DNA or RNA. This test is crucial in identifying the presence of GAS, which is primarily transmitted via respiratory droplets and direct contact with infected skin lesions, such as those seen in impetigo. Additionally, there have been instances of transmission through contaminated food and water. The clinical manifestations of GAS infections are diverse, commonly presenting as respiratory and skin infections, but can also lead to more severe conditions such as meningitis, osteomyelitis, toxic shock syndrome, and necrotizing fasciitis. The direct probe technique utilized in this test focuses on identifying a unique nucleic acid sequence, referred to as the target sequence, specific to the GAS bacterium. This is achieved by using a probe that is labeled with either fluorescent or chemiluminescent markers. During the testing process, the sample is treated to release nucleic acids from the target organism, if present. The labeled probe then selectively binds to the matching target sequence, forming a stable hybrid. Ribosomal RNA is often the target of this detection method due to its abundance in microorganisms, as it is typically present in thousands of copies compared to the limited 1-2 copies found in genomic DNA. For enhanced sensitivity, an amplified probe technique (CPT® Code 87651) may be employed, which involves exponentially multiplying the target sequence of GAS DNA or RNA into millions of copies. The polymerase chain reaction (PCR) or reverse transcriptase polymerase chain reaction (RT-PCR) are the most commonly used amplification methods. Furthermore, nucleic acid detection with quantification (CPT® Code 87652) allows for an assessment of the quantity of microorganisms present by utilizing quantitative or real-time PCR to amplify the isolated nucleic acid segment and generate reports documenting the absolute or relative amounts of the known nucleic acid sequence at each stage of the process.
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The CPT® Code 87650 is indicated for the detection of Streptococcus, group A (GAS) in various clinical scenarios. The following conditions and symptoms may warrant the use of this test:
The procedure for CPT® Code 87650 involves several key steps to ensure accurate detection of Streptococcus, group A. The following outlines the procedural steps:
After the completion of the procedure associated with CPT® Code 87650, the laboratory will analyze the results and report the findings. The expected outcome is a clear indication of whether Streptococcus, group A is present in the sample. If GAS is detected, appropriate clinical management and treatment options can be discussed with the patient. It is important for healthcare providers to interpret the results in conjunction with clinical findings and other diagnostic tests. Follow-up care may be necessary depending on the patient's condition and the results of the test.
| Short Descr | STREP A DNA DIR PROBE | Medium Descr | IADNA STREPTOCOCCUS GROUP A DIRECT PROBE TQ | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct 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) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 206 - Microscopic examination (bacterial smear, culture, toxicology) |
| 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. | TA | Left foot, great toe | T6 | Right foot, second digit | T5 | Right foot, great toe | T1 | Left foot, second digit | T9 | Right foot, fifth digit | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) | T2 | Left foot, third digit | T3 | Left foot, fourth digit | T4 | Left foot, fifth digit | T7 | Right foot, third digit | T8 | Right foot, fourth digit | 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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| 2011-01-01 | Changed | Short description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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