How To Use CPT Code 87542

CPT 87542 describes the quantification of the bacteria Legionella pneumophila using nucleic acid probe 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 87542?

CPT 87542 can be used to describe the quantification of Legionella pneumophila, a bacteria that can cause pneumonia outbreaks known as Legionnaires’ disease. This code is used when a lab analyst performs a test using nucleic acid probe technique to assess the presence and quantity of L. pneumophila in a specimen.

2. Official Description

The official description of CPT code 87542 is: ‘Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification.’

3. Procedure

1. The lab analyst receives a specimen, typically sputum, pleural fluid, or lung tissue, and processes it for analysis.
2. The lab analyst performs amplification techniques, such as polymerase chain reaction (PCR), to increase the number of copies of the specific target nucleic acid sequence.
3. The lab analyst evaluates the amplified nucleic acid sequences using a nucleic acid probe, which is a fabricated single strand sequence of DNA or RNA.
4. The lab analyst quantifies the presence of L. pneumophila by visualizing and measuring the hybridization product formed between the probe and the complementary sequence in the specimen.

4. Qualifying circumstances

CPT 87542 is used when there is a need to detect and quantify Legionella pneumophila in a specimen. This test may be ordered by clinicians to diagnose infection with L. pneumophila, which can cause pneumonia, flu-like illness, fever, diarrhea, or shortness of breath. The test can be performed on specimens such as sputum, pleural fluid, or lung tissue.

5. When to use CPT code 87542

CPT code 87542 should be used when there is a need to quantify the presence of Legionella pneumophila using nucleic acid probe technique. It is appropriate to bill this code when the lab analyst performs the test and provides the results.

6. Documentation requirements

To support a claim for CPT 87542, the following documentation is required:

• Specimen source (e.g., sputum, pleural fluid, lung tissue)
• Amplification techniques used (e.g., PCR)
• Details of the nucleic acid probe used
• Date of the test
• Results of the quantification
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 87542, ensure that the test is performed to quantify Legionella pneumophila using nucleic acid probe technique. There are no specific guidelines regarding reporting this code with other codes. However, it is important to accurately document and code the services provided.

8. Historical information

CPT 87542 was added to the Current Procedural Terminology system on January 1, 1998. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs a test to quantify Legionella pneumophila in a sputum specimen using nucleic acid probe technique.
2. A patient presents with symptoms of pneumonia, and a lab analyst performs a test to quantify Legionella pneumophila in their pleural fluid sample.
3. A healthcare provider suspects Legionnaires’ disease in a patient and orders a test to quantify Legionella pneumophila in their lung tissue.
4. A lab analyst performs a test to quantify Legionella pneumophila in a sputum specimen using nucleic acid probe technique.
5. A patient with flu-like symptoms undergoes a test to quantify Legionella pneumophila in their pleural fluid sample.
6. A healthcare provider suspects Legionnaires’ disease in a patient and orders a test to quantify Legionella pneumophila in their lung tissue.
7. A lab analyst performs a test to quantify Legionella pneumophila in a sputum specimen using nucleic acid probe technique.
8. A patient presents with symptoms of pneumonia, and a lab analyst performs a test to quantify Legionella pneumophila in their pleural fluid sample.
9. A healthcare provider suspects Legionnaires’ disease in a patient and orders a test to quantify Legionella pneumophila in their lung tissue.
10. A lab analyst performs a test to quantify Legionella pneumophila in a sputum specimen using nucleic acid probe technique.