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The CPT® Code 87797 refers to a laboratory test designed for the detection of infectious agents through the analysis of nucleic acids, specifically DNA or RNA. This procedure is categorized as "not otherwise specified" (NOS), indicating that it can be applied to a variety of infectious organisms that are not explicitly listed. Examples of such organisms include West Nile Virus, Human T-Lymphotropic Virus, Epstein Barr Virus, BK Virus, Adenovirus, Hepatitis E Virus, Parvovirus B19, and Human Herpesvirus 8. The test employs a direct probe technique, which involves identifying a unique nucleic acid sequence known as the target sequence that corresponds to the suspected infectious agent. This target sequence is sought within samples derived from blood, tissue, or other bodily fluids. To perform the test, the sample is treated to release nucleic acids from the target organism, if it is present. A labeled probe, which may utilize fluorescent or chemiluminescent markers, is then introduced to the sample. This probe is designed to bind specifically to the target sequence, forming a stable hybrid if the sequence is present. The method often targets ribosomal RNA, as it is typically found in high quantities within microorganisms, making it a reliable indicator for detection. In contrast, the amplified probe technique, represented by CPT® Code 87798, enhances the sensitivity of the assay by exponentially amplifying the target sequence of the organism's DNA or RNA, resulting in millions of copies. The polymerase chain reaction (PCR) or reverse transcriptase polymerase chain reaction (RT-PCR) is the most frequently utilized amplification method. Following amplification, the replicated sequences are identified using labeled DNA probes. Furthermore, CPT® Code 87799 pertains to nucleic acid detection that includes quantification, allowing for an assessment of the number of microorganisms present in the sample. This quantitative approach often employs real-time PCR to amplify the nucleic acid segment and generate detailed reports on the absolute or relative amounts of the identified nucleic acid sequence.
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The CPT® Code 87797 is indicated for the detection of infectious agents that are not otherwise specified. This test is particularly useful in cases where a patient presents with symptoms of an infectious disease, but the specific causative organism has not been identified. The following conditions may warrant the use of this procedure:
The procedure for CPT® Code 87797 involves several critical steps to ensure accurate detection of the infectious agent. The following outlines the procedural steps:
After the completion of the procedure associated with CPT® Code 87797, the laboratory will analyze the results to determine the presence of the infectious agent. The findings will be documented in a report, which will include details on whether the target nucleic acid sequence was detected. Depending on the results, further clinical evaluation or treatment may be necessary. It is important for healthcare providers to interpret the results in conjunction with the patient's clinical presentation and history. Follow-up testing or additional diagnostic procedures may be warranted based on the initial findings.
| Short Descr | DETECT AGENT NOS DNA DIR | Medium Descr | IADNA NOS DIRECT PROBE TQ EACH ORGANISM | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism | 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 | 3 | CCS Clinical Classification | 206 - Microscopic examination (bacterial smear, culture, toxicology) |
| AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 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. | Q4 | Service for ordering/referring physician qualifies as a service exemption |
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| 2011-01-01 | Changed | Short description changed. |
| 2001-01-01 | Changed | Code description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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