How To Use CPT Code 87166

CPT 87166 describes the dark field examination procedure, which involves the microscopic examination of a direct specimen from any patient source using dark field microscopy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 87166?

CPT 87166 can be used to describe the dark field examination procedure performed by a lab analyst. This procedure involves the examination of a direct specimen from any patient source using dark field microscopy. Dark field microscopy is a method that excludes unscattered background light from the microscopic image, allowing the analyst to see a very dark background with bright objects on it. This procedure is typically ordered by clinicians to aid in the diagnosis of conditions caused by organisms that are difficult to culture and observe using traditional light microscopy.

2. Official Description

The official description of CPT code 87166 is: ‘Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection.’

3. Procedure

1. The lab analyst receives a direct specimen from the patient, such as a smear from a penile lesion.
2. The lab analyst performs a microscopic examination of the specimen using dark field microscopy.
3. Dark field microscopy excludes unscattered background light, allowing the analyst to observe a very dark background with bright objects on it.
4. The lab analyst examines the specimen for the presence of organisms or other abnormalities that may aid in the diagnosis of the patient’s condition.
5. The lab analyst documents their findings and prepares a report for the clinician.

4. Qualifying circumstances

CPT 87166 can be used for any patient source, such as penile, vaginal, oral, or skin specimens, that require a dark field examination. This procedure is typically ordered by clinicians to aid in the diagnosis of conditions caused by organisms that are difficult to culture and observe using traditional light microscopy. It is important to note that CPT 87166 does not include specimen collection.

5. When to use CPT code 87166

CPT code 87166 should be used when a dark field examination is performed on a direct specimen from any patient source using dark field microscopy. This code should not be used if specimen collection is involved, as there is a separate code (CPT 87164) for that specific procedure.

6. Documentation requirements

To support a claim for CPT 87166, the lab analyst must document the following information:

• Patient’s source of the specimen (eg, penile, vaginal, oral, skin)
• Description of the specimen received
• Date and time of the dark field examination
• Findings of the examination, including any organisms or abnormalities observed
• Preparation of a report for the clinician

7. Billing guidelines

When billing for CPT 87166, ensure that the procedure involves a dark field examination of a direct specimen from any patient source. It is important to distinguish CPT 87166 from CPT 87164, which includes specimen collection. There are no specific guidelines regarding reporting CPT 87166 with other codes. However, it is important to follow any applicable bundling or unbundling rules and guidelines provided by payers.

8. Historical information

CPT 87166 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs a dark field examination on a direct specimen from a penile lesion to aid in the diagnosis of primary syphilis.
2. A lab analyst examines a direct specimen from an oral ulceration using dark field microscopy to aid in the diagnosis of a condition caused by difficult-to-observe organisms.
3. A lab analyst performs a dark field examination on a direct specimen from a skin lesion to aid in the diagnosis of a condition caused by organisms that are difficult to culture.
4. A lab analyst examines a direct specimen from a vaginal source using dark field microscopy to aid in the diagnosis of a condition caused by organisms that are not easily observed using traditional light microscopy.
5. A lab analyst performs a dark field examination on a direct specimen from a patient’s oral cavity to aid in the diagnosis of a condition caused by difficult-to-observe organisms.
6. Provide four more examples of cases in which CPT code 87166 should be billed. Only explain the examples and make them all original. Do not include ‘CPT 87166” or ‘CPT code 87166” in the text of an example.