How To Use CPT Code 87451

CPT 87451 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 87451?

CPT 87451 can be used to detect antigens of multiple organisms in a patient’s specimen using an immunoassay technique. This code is used when the lab analyst performs all the necessary steps to assess the presence of specific protein particles on multiple organisms, such as viruses, bacteria, fungi, or protozoa. The immunoassay techniques that may be used include enzyme immunoassay (EIA), enzyme-linked immunosorbent assay (ELISA), fluorescence immunoassay (FIA), or immunochemiluminometric assay (IMCA).

2. Official Description

The official description of CPT code 87451 is: ‘Infectious agent antigen detection by immunoassay technique (eg, EIA, ELISA, FIA, IMCA), qualitative or semiquantitative; polyvalent for multiple organisms, each polyvalent antiserum.’

3. Procedure

1. The lab analyst performs an immunoassay technique on a primary source specimen, such as blood or stool, from the patient.
2. The analyst assesses the presence of antigens, which are specific protein particles, on multiple organisms using techniques like EIA, ELISA, FIA, or IMCA.
3. The test evaluates for more than one organism, even if one of the organisms is listed in separate immunoassay codes.
4. If the lab analyst performs this test for different species or strains of the organism, or different organisms, each test should be reported separately with modifier 59, Distinct procedural service.

4. Qualifying circumstances

CPT 87451 is used when clinicians order a test to diagnose or rule out possible infection with multiple organisms. The test is not limited to a specific condition and can be used to screen for multiple organisms that cause various infections. The presence of antigens in the patient’s specimen indicates an active infection with disease-causing organisms. This code should be reserved for primary source specimens and should not be used for testing culture isolates.

5. When to use CPT code 87451

CPT code 87451 should be used when the immunoassay technique is used to evaluate for antigens of multiple organisms in a patient’s specimen. It is appropriate to use this code when the test uses immunoassay to assess the presence of antigens on more than one organism, even if one of the organisms is listed in separate immunoassay codes.

6. Documentation requirements

To support a claim for CPT 87451, the documentation should include:

• Details of the primary source specimen used for testing
• Explanation of the immunoassay technique used, such as EIA, ELISA, FIA, or IMCA
• Identification of the multiple organisms being tested for
• Date and time of the test
• Results of the test indicating the presence or absence of antigens
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 87451, ensure that the test uses an immunoassay technique to evaluate for antigens of multiple organisms. This code should not be reported for testing culture isolates. If the lab analyst performs this test for different species or strains of the organism, or different organisms, each test should be reported separately with modifier 59, Distinct procedural service.

8. Historical information

CPT 87451 was added to the Current Procedural Terminology system on January 1, 2001. There have been several updates to the code since its addition, including changes to the description and methodology.

9. Examples

1. A lab analyst performs an immunoassay technique to detect antigens of multiple organisms in a patient’s blood sample.
2. The immunoassay technique is used to evaluate for antigens of various viruses in a patient’s respiratory specimen.
3. A lab analyst performs an immunoassay technique to detect antigens of multiple organisms in a patient’s stool sample.
4. The immunoassay technique is used to evaluate for antigens of different bacteria in a patient’s wound specimen.
5. A lab analyst performs an immunoassay technique to detect antigens of multiple organisms in a patient’s cerebrospinal fluid sample.
6. The immunoassay technique is used to evaluate for antigens of various fungi in a patient’s skin specimen.
7. A lab analyst performs an immunoassay technique to detect antigens of multiple organisms in a patient’s urine sample.
8. The immunoassay technique is used to evaluate for antigens of different protozoa in a patient’s gastrointestinal specimen.
9. A lab analyst performs an immunoassay technique to detect antigens of multiple organisms in a patient’s synovial fluid sample.
10. The immunoassay technique is used to evaluate for antigens of various viruses in a patient’s ocular specimen.