How To Use CPT Code 87254

CPT 87254 describes the virus isolation procedure using the centrifuge-enhanced (shell vial) technique, including identification with immunofluorescence stain. 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 87254?

CPT 87254 can be used to describe the technical lab test performed by a lab analyst to isolate and identify a virus in a blood or other sample. This procedure involves using the centrifuge-enhanced (shell vial) technique and identifying the virus with immunofluorescence stain. Each virus tested should be reported with this code.

2. Official Description

The official description of CPT code 87254 is: ‘Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus.’

3. Procedure

1. The lab analyst places the specimen on a small coverslip in a shell vial culture tube.
2. The tube is then spun down in a centrifuge set at a slow speed.
3. The analyst incubates the tube and identifies the virus after incubation using an immunofluorescence stain.
4. The immunofluorescence stain contains antibodies to the specific virus that are tagged with a fluorescent dye.
5. If the specific virus is present in the specimen, it will combine with the fluorescent antibody and form a molecule that the analyst can see under the fluorescent microscope.
6. If the virus is not present, the analyst will see no fluorescence when looking under the microscope.

4. Qualifying circumstances

CPT 87254 is performed when there is a need to isolate and identify a virus in a blood or other sample. This test can identify various viruses, including influenza A and B, cytomegalovirus (CMV), respiratory syncytial virus (RSV), parainfluenza, coxsackievirus, herpes simplex, polio, measles, mumps, and rhinovirus. It is important to note that this test is not limited to testing for a specific condition.

5. When to use CPT code 87254

CPT code 87254 should be used when performing the virus isolation procedure using the centrifuge-enhanced (shell vial) technique and identifying the virus with immunofluorescence stain. This code should be reported for each virus tested.

6. Documentation requirements

To support a claim for CPT 87254, the documentation should include:

• The specific virus tested
• The centrifuge-enhanced (shell vial) technique used
• The date of the procedure
• The start and end time of the procedure
• The results of the immunofluorescence stain
• The signature of the lab analyst performing the procedure

7. Billing guidelines

When billing for CPT 87254, ensure that the virus isolation procedure using the centrifuge-enhanced (shell vial) technique and identification with immunofluorescence stain is performed. This code should be reported for each virus tested. It is important to note that CPT code 87254 should not be reported with other codes for virus isolation procedures. Additionally, some payers may separately reimburse for the collection of the specimen.

8. Historical information

CPT 87254 was added to the Current Procedural Terminology system on January 1, 2001. There have been historical changes to the code, including a code change on January 1, 2003, which updated the description to include the centrifuge-enhanced (shell vial) technique.

9. Examples

1. A lab analyst performs the virus isolation procedure using the centrifuge-enhanced (shell vial) technique and identifies influenza A and B in a blood sample.
2. The virus isolation procedure using the centrifuge-enhanced (shell vial) technique is performed by a lab analyst, and cytomegalovirus (CMV) is identified in a tissue sample.
3. A blood sample is analyzed by a lab analyst using the virus isolation procedure with the centrifuge-enhanced (shell vial) technique, and respiratory syncytial virus (RSV) is identified.
4. The virus isolation procedure using the centrifuge-enhanced (shell vial) technique is performed by a lab analyst, and parainfluenza is identified in a throat swab sample.
5. A lab analyst performs the virus isolation procedure using the centrifuge-enhanced (shell vial) technique and identifies coxsackievirus in a stool sample.
6. The virus isolation procedure using the centrifuge-enhanced (shell vial) technique is performed by a lab analyst, and herpes simplex is identified in a genital swab sample.
7. A lab analyst analyzes a blood sample using the virus isolation procedure with the centrifuge-enhanced (shell vial) technique, and polio is identified.
8. The virus isolation procedure using the centrifuge-enhanced (shell vial) technique is performed by a lab analyst, and measles is identified in a throat swab sample.
9. A lab analyst performs the virus isolation procedure using the centrifuge-enhanced (shell vial) technique and identifies mumps in a saliva sample.
10. The virus isolation procedure using the centrifuge-enhanced (shell vial) technique is performed by a lab analyst, and rhinovirus is identified in a nasal swab sample.