How To Use CPT Code 87633

CPT 87633 is a code used for the detection of respiratory viruses through nucleic acid testing, covering 12-25 targets. This article will discuss the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 87633.

1. What is CPT 87633?

CPT 87633 is a medical billing code used for the detection of respiratory viruses through nucleic acid testing, specifically DNA or RNA. This code covers the detection of 12-25 target viruses, including adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, and rhinovirus. The procedure involves the use of multiplex reverse transcription and amplified probe techniques.

2. 87633 CPT code description

The official description of CPT code 87633 is: “Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 12-25 targets.”

3. Procedure

The 87633 procedure involves the following steps:

  1. Collection of a specimen from the patient, typically through a blood sample or a swab from the respiratory tract.
  2. Extraction of nucleic acids (DNA or RNA) from the specimen.
  3. Amplification of the target nucleic acid sequences using polymerase chain reaction (PCR) or another amplification technique.
  4. Hybridization of the amplified nucleic acid sequences with a labeled nucleic acid probe specific to the target respiratory viruses.
  5. Detection and identification of the target respiratory viruses based on the presence of the labeled hybridization product.

4. Qualifying circumstances

Patients eligible to receive CPT code 87633 services are those who present with symptoms of respiratory infection or illness, such as fever, cough, sore throat, or difficulty breathing. This test may be ordered by a healthcare provider to diagnose the specific respiratory virus causing the patient’s symptoms and to guide appropriate treatment.

5. When to use CPT code 87633

It is appropriate to bill the 87633 CPT code when a healthcare provider orders a nucleic acid test to detect and identify 12-25 target respiratory viruses in a patient presenting with symptoms of respiratory infection or illness. This code should be used when the test involves multiplex reverse transcription and amplified probe techniques.

6. Documentation requirements

To support a claim for CPT 87633, the following information should be documented:

  • Patient’s demographic information, including name, date of birth, and insurance information.
  • Patient’s clinical history and presenting symptoms.
  • Healthcare provider’s order for the nucleic acid test, including the specific respiratory viruses to be detected and the reason for the test.
  • Details of the specimen collection, including the date, time, and method of collection.
  • Results of the nucleic acid test, including the detected respiratory viruses and their corresponding target sequences.
  • Interpretation of the test results by the healthcare provider and any subsequent treatment recommendations.

7. Billing guidelines

When billing for CPT code 87633, it is important to follow the appropriate billing guidelines and rules. Some payers may require separate billing for specimen collection, such as using code 36415 for venipuncture. Additionally, ensure proper reporting of CPT codes 87632 and 87633, depending on the number of target viruses being detected (6-11 targets for 87632, 12-25 targets for 87633).

8. Historical information

CPT 87633 was added to the Current Procedural Terminology system on January 1, 2013. The code was changed on January 1, 2015, with the previous descriptor being “Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), multiplex reverse transcription and amplified probe technique, multiple types or subtypes, 12-25 targets.”

9. Similar codes to CPT 87633

Five similar codes to CPT 87633 and how they differentiate are:

  • CPT 87631: This code is used for the detection of 2-5 target respiratory viruses.
  • CPT 87632: This code is used for the detection of 6-11 target respiratory viruses.
  • CPT 87501: This code is used for the detection of influenza virus types A and B only.
  • CPT 87502: This code is used for the detection of influenza virus types A and B, with subtyping.
  • CPT 87800: This code is used for the detection of multiple infectious agents not otherwise specified, reporting a single result.

10. Examples

Here are 10 detailed examples of CPT code 87633 procedures:

  1. A patient presents with fever, cough, and shortness of breath. The healthcare provider orders a nucleic acid test to detect 15 target respiratory viruses, including influenza A and B, coronavirus, and respiratory syncytial virus.
  2. A child with a high fever and severe cough is tested for 20 target respiratory viruses, including parainfluenza virus and metapneumovirus, using a multiplex reverse transcription and amplified probe technique.
  3. An elderly patient with pneumonia symptoms undergoes a nucleic acid test to detect 12 target respiratory viruses, including adenovirus and rhinovirus.
  4. A patient with a history of chronic obstructive pulmonary disease (COPD) presents with worsening respiratory symptoms and is tested for 25 target respiratory viruses to determine the cause of the exacerbation.
  5. A patient with a compromised immune system presents with respiratory symptoms and is tested for 18 target respiratory viruses to guide appropriate treatment and prevent complications.
  6. An outbreak of respiratory illness occurs in a long-term care facility, and residents are tested for 22 target respiratory viruses to identify the causative agent and implement infection control measures.
  7. A patient with asthma presents with an acute respiratory infection and is tested for 14 target respiratory viruses, including respiratory syncytial virus and coronavirus, to determine the cause and guide treatment.
  8. A patient with a persistent cough and fever undergoes a nucleic acid test to detect 16 target respiratory viruses, including influenza A and B, parainfluenza virus, and metapneumovirus.
  9. A patient with a history of recurrent respiratory infections is tested for 24 target respiratory viruses to identify any underlying viral cause and guide appropriate treatment.
  10. An infant with bronchiolitis symptoms is tested for 12 target respiratory viruses, including respiratory syncytial virus and rhinovirus, to determine the cause and guide treatment.

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