How To Use CPT Code 87253

CPT 87253 describes the additional studies or definitive identification of a virus isolate using tissue culture methodology. 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 87253?

CPT 87253 can be used to specifically identify a virus from a patient specimen that has been previously isolated and identified using tissue culture methodology. This code is used when additional tests, such as hemadsorption, neutralization, or immunofluorescence stain, are performed on the tissue culture virus isolate to definitively identify the virus.

2. Official Description

The official description of CPT code 87253 is: ‘Virus isolation; tissue culture, additional studies or definitive identification (eg, hemadsorption, neutralization, immunofluorescence stain), each isolate.’

3. Procedure

1. Following a tissue culture procedure to isolate and presumptively identify a virus, the lab analyst performs additional tests on the tissue culture virus isolate.
2. These additional tests may include hemadsorption, neutralization, or immunofluorescence stain.
3. Hemadsorption identifies certain viruses that cause infected cells to bind to red blood cells.
4. Neutralization involves an antibody reaction with fluid from the tissue culture.
5. Immunofluorescence stain involves an immunoassay reaction with a fluorescent marker that is visible with a specialized microscope.
6. One unit of CPT 87253 represents additional tests for a single virus isolate.

4. Qualifying circumstances

CPT 87253 is used when there is a need to definitively identify a specific virus that is infecting the patient. This test may be ordered for various conditions, such as adenovirus, cytomegalovirus, enterovirus, Epstein Barr virus, influenza virus, poliovirus, or rhinovirus. The test is performed on a virus isolate that has been previously obtained through tissue culture methodology.

5. When to use CPT code 87253

CPT code 87253 should be used when additional studies or definitive identification of a virus isolate are required using tissue culture methodology. This code should not be used for virus identification using non-immunologic methods or for virus isolation using cytopathic effect evaluation alone.

6. Documentation requirements

To support a claim for CPT 87253, the following documentation is required:

• Documentation of the tissue culture procedure and presumptive identification of the virus
• Specific tests performed on the virus isolate, such as hemadsorption, neutralization, or immunofluorescence stain
• Results of the additional tests and definitive identification of the virus
• Signature of the lab analyst performing the tests

7. Billing guidelines

When billing for CPT 87253, ensure that the additional studies or definitive identification of the virus isolate using tissue culture methodology have been performed. Do not report CPT 87253 with CPT code 87255 for the same specimen, as each code represents virus identification using different methodology.

8. Historical information

CPT 87253 was added to the Current Procedural Terminology system on January 1, 1990. There have been changes to the code over the years, including updates to the code description and the addition of notes.

9. Examples

1. A lab analyst performs additional tests on a tissue culture virus isolate to definitively identify the adenovirus causing an infection in a patient.
2. After isolating and identifying a virus using tissue culture methodology, the lab analyst performs hemadsorption and neutralization tests to definitively identify the cytomegalovirus in a patient specimen.
3. Using tissue culture methodology, the lab analyst performs immunofluorescence stain on a virus isolate to definitively identify the influenza virus in a patient sample.
4. Following the isolation and presumptive identification of a virus using tissue culture, the lab analyst performs additional studies, including hemadsorption and neutralization, to definitively identify the poliovirus in a patient specimen.
5. After isolating and identifying a virus using tissue culture methodology, the lab analyst performs immunofluorescence stain to definitively identify the rhinovirus causing a respiratory infection in a patient.