How To Use CPT Code 87593

CPT 87593 is a code used for the detection of infectious agents by nucleic acid (DNA or RNA) in orthopoxvirus, using an amplified probe technique. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 87593.

1. What is CPT 87593?

CPT 87593 is a medical code used to describe a laboratory test that detects the presence of nucleic acids (DNA or RNA) of orthopoxvirus organisms, such as monkeypox virus, cowpox virus, or vaccinia virus, using an amplified probe technique. This test is essential for diagnosing patients with symptoms consistent with orthopox, such as monkeypox, which may include a rash or skin lesions.

2. 87593 CPT code description

The official description of CPT code 87593 is: “Infectious agent detection by nucleic acid (DNA or RNA); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each.”

3. Procedure

The procedure for CPT 87593 involves the following steps:

1. Collection of a specimen, such as a skin-lesion swab, from the patient.
2. Processing of the specimen in the laboratory to extract nucleic acids.
3. Amplification of specific nucleic acid sequences, if present, for orthopoxvirus viral targets using techniques like polymerase chain reaction (PCR).
4. Assessment of the presence of amplified nucleic acid sequences using nucleic acid probes, which are single-strand sequences of DNA or RNA designed to bind with the complementary sequence in the specimen through a process called hybridization.
5. Visualization of the hybridization product using a labeled probe, such as a fluorescent tag, to detect the presence of target infectious-agent nucleic acids in the specimen.

4. Qualifying circumstances

Patients eligible to receive CPT code 87593 services are those who exhibit symptoms consistent with orthopox, such as monkeypox. Symptoms may include a rash or skin lesions. Clinicians may order this test to diagnose patients with these symptoms or to differentiate between orthopoxviruses in cases where the specific virus is unknown.

5. When to use CPT code 87593

It is appropriate to bill the 87593 CPT code when a clinician orders a laboratory test to detect the presence of nucleic acids (DNA or RNA) of orthopoxvirus organisms in a patient’s specimen, using an amplified probe technique. This test is typically ordered for patients with symptoms consistent with orthopox, such as monkeypox, or to differentiate between orthopoxviruses when the specific virus is unknown.

6. Documentation requirements

To support a claim for CPT 87593, the following information needs to be documented:

• Patient’s demographic information, including name, date of birth, and medical record number.
• Clinical history and symptoms consistent with orthopox, such as monkeypox.
• Indication for the test, including the suspected orthopoxvirus or the need to differentiate between orthopoxviruses.
• Details of the specimen collection, including the type of specimen (e.g., skin-lesion swab) and the date of collection.
• Results of the test, including the presence or absence of target infectious-agent nucleic acids in the specimen.
• Interpretation of the test results by the ordering clinician.

7. Billing guidelines

When billing for CPT code 87593, it is essential to follow the appropriate guidelines and rules. Report one unit of this code for each unique amplified probe test for each general or specific orthopoxvirus assay. CPT 87593 is a child code under parent code 87471. Ensure that the documentation requirements mentioned above are met to support the claim for this code.

8. Historical information

CPT 87593 was added to the Current Procedural Terminology system on July 26, 2022. There have been no updates to this code since its addition.

9. Similar codes to CPT 87593

Five similar codes to CPT 87593 and how they differentiate from CPT 87593 are:

1. CPT 87471: This parent code is for the detection of infectious agents by nucleic acid (DNA or RNA) using an amplified probe technique, but it does not specify orthopoxvirus.
2. CPT 87591: This code is for the detection of infectious agents by nucleic acid (DNA or RNA) in Neisseria gonorrhoeae, using an amplified probe technique.
3. CPT 87592: This code is for the detection of infectious agents by nucleic acid (DNA or RNA) in Chlamydia trachomatis, using an amplified probe technique.
4. CPT 87594: This code is for the detection of infectious agents by nucleic acid (DNA or RNA) in human papillomavirus (HPV), using an amplified probe technique.
5. CPT 87595: This code is for the detection of infectious agents by nucleic acid (DNA or RNA) in human immunodeficiency virus-1 (HIV-1), using an amplified probe technique.

10. Examples

Here are 10 detailed examples of CPT code 87593 procedures:

1. A patient presents with a rash and skin lesions consistent with monkeypox. The clinician orders a test to detect the presence of monkeypox virus nucleic acids using an amplified probe technique.
2. A patient with a history of exposure to an individual with monkeypox develops symptoms consistent with the infection. The clinician orders a test to confirm the presence of monkeypox virus nucleic acids in the patient’s specimen.
3. A patient with a suspected orthopoxvirus infection has a skin-lesion swab collected and tested for the presence of orthopoxvirus nucleic acids using an amplified probe technique.
4. A patient with a rash and skin lesions has a test ordered to differentiate between orthopoxviruses, such as monkeypox virus and cowpox virus, using an amplified probe technique.
5. A patient with a history of exposure to animals known to carry orthopoxviruses develops symptoms consistent with an orthopoxvirus infection. The clinician orders a test to detect the presence of orthopoxvirus nucleic acids in the patient’s specimen.
6. A patient with a suspected orthopoxvirus infection has a test ordered to confirm the presence of vaccinia virus nucleic acids using an amplified probe technique.
7. A patient with a rash and skin lesions has a test ordered to detect the presence of cowpox virus nucleic acids using an amplified probe technique.
8. A patient with a history of exposure to an individual with an orthopoxvirus infection has a test ordered to confirm the presence of orthopoxvirus nucleic acids in the patient’s specimen.
9. A patient with a suspected orthopoxvirus infection has a test ordered to differentiate between monkeypox virus and vaccinia virus nucleic acids using an amplified probe technique.
10. A patient with a rash and skin lesions has a test ordered to detect the presence of orthopoxvirus nucleic acids in the patient’s specimen, using an amplified probe technique, to confirm the diagnosis of an orthopoxvirus infection.