How To Use CPT Code 87430

CPT 87430 describes the detection of infectious agent antigens using an immunoassay technique. 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 87430?

CPT 87430 can be used to detect the presence of infectious agent antigens, specifically Streptococcus group A, using an immunoassay technique. This code is used when a lab analyst performs an assay to evaluate a patient’s sample for the presence of these antigens.

2. Official Description

The official description of CPT code 87430 is: ‘Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; Streptococcus, group A.’

3. Procedure

1. The lab analyst performs an immunoassay technique, such as EIA or ELISA, to test the patient’s specimen for the presence of Streptococcus group A antigens.

4. Qualifying circumstances

CPT 87430 is used when there is a need to diagnose Streptococcus group A infections, particularly in patients experiencing pharyngitis or sore throat. The test helps identify the presence of these antigens, which, if left untreated, can lead to complications such as rheumatic fever and kidney failure. It is important to note that this code should only be used for primary source specimens and not for testing culture isolates.

5. When to use CPT code 87430

CPT code 87430 should be used when there is a clinical suspicion of a Streptococcus group A infection and the lab analyst performs an immunoassay technique to detect the presence of antigens. It is important to follow the specific guidelines and not report this code if other methods or more specific codes are used for testing.

6. Documentation requirements

To support a claim for CPT 87430, the documentation should include:

• Reason for ordering the test and the clinical suspicion of a Streptococcus group A infection
• Details of the immunoassay technique used, such as EIA or ELISA
• Date and time of the test
• Results of the test indicating the presence or absence of Streptococcus group A antigens
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 87430, ensure that the test is performed using an immunoassay technique to detect Streptococcus group A antigens. It is important to follow the specific guidelines and not report this code if other methods or more specific codes are used for testing. Additionally, consider any applicable modifiers or billing requirements set by the payer.

8. Historical information

CPT 87430 was added to the Current Procedural Terminology system on January 1, 1998. There have been several updates and changes to the code over the years, including modifications to the description and the addition of new immunoassay techniques.

9. Examples

1. A lab analyst performs an immunoassay technique to detect the presence of Streptococcus group A antigens in a patient’s throat swab sample.
2. An immunoassay method, such as EIA or ELISA, is used to evaluate a patient’s specimen for the presence of Streptococcus group A antigens.
3. A lab technician performs an immunoassay technique to detect the antigens of Streptococcus group A in a patient’s sample.
4. An immunoassay test is conducted to identify the presence of Streptococcus group A antigens in a patient’s specimen.
5. A patient’s sample is tested using an immunoassay technique to detect the antigens of Streptococcus group A.
6. An immunoassay method, such as FIA or IMCA, is used to evaluate a patient’s specimen for the presence of Streptococcus group A antigens.
7. A lab analyst performs an immunoassay technique to detect the presence of Streptococcus group A antigens in a patient’s sample.
8. An immunoassay test is conducted to identify the presence of Streptococcus group A antigens in a patient’s throat swab.
9. A patient’s specimen is tested using an immunoassay technique to detect the antigens of Streptococcus group A.
10. An immunoassay method, such as EIA or ELISA, is used to evaluate a patient’s sample for the presence of Streptococcus group A antigens.