How To Use CPT Code 87551

CPT 87551 describes the detection of Mycobacterium species using an amplified 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 87551?

CPT 87551 can be used to detect the presence of Mycobacterium species using an amplified nucleic acid probe technique. This code is used when a lab analyst performs a test on a specimen, such as blood, sputum, or a swab, to assess the presence of Mycobacterium. The test involves amplification techniques, like polymerase chain reaction (PCR), to increase the number of copies of a specific target nucleic acid sequence. The lab analyst then uses a nucleic acid probe, which is a fabricated single strand sequence of DNA or RNA, to join with the complementary sequence in the specimen through hybridization. The presence of the amplified nucleic acid sequences indicates the presence of Mycobacterium.

2. Official Description

The official description of CPT code 87551 is: ‘Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, amplified probe technique.’

3. Procedure

1. The lab analyst processes the specimen, typically blood, sputum, or a swab, from a direct source.
2. Amplification techniques, such as polymerase chain reaction (PCR), are performed to increase the number of copies of a specific target nucleic acid sequence.
3. The lab analyst assesses the presence of the amplified nucleic acid sequences that indicate the presence of Mycobacterium using a nucleic acid probe.
4. The nucleic acid probe, a fabricated single strand sequence of DNA or RNA, joins with the complementary sequence in the specimen through hybridization.
5. The lab analyst visualizes the hybridization product using a label, such as a radioactive or chemical tag, attached to the nucleic acid probe.

4. Qualifying circumstances

CPT 87551 is used when a clinician suspects an atypical cause of infection and orders a test to detect Mycobacterium species. This test can be used to detect various Mycobacterium species that may cause respiratory infections, wound infections, systemic infections, or even leprosy. It is important to note that there are specific codes available for testing for Mycobacterium tuberculosis or Mycobacterium avium intracellulare.

5. When to use CPT code 87551

CPT code 87551 should be used when a clinician orders a test to detect the presence of Mycobacterium species using an amplified nucleic acid probe technique. It is appropriate to use this code when the test is performed on a specimen, such as blood, sputum, or a swab, and the results are used to diagnose or monitor an infection caused by Mycobacterium.

6. Documentation requirements

To support a claim for CPT 87551, the documentation should include:

• Reason for ordering the test and suspicion of Mycobacterium infection
• Details of the specimen processed, such as blood, sputum, or swab
• Description of the amplification techniques used, such as polymerase chain reaction (PCR)
• Results of the test indicating the presence of Mycobacterium
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 87551, ensure that the test is performed using an amplified nucleic acid probe technique to detect Mycobacterium species. It is important to use the specific code for Mycobacterium tuberculosis or Mycobacterium avium intracellulare if testing for these specific species. Additionally, some payers may separately reimburse for the collection of the specimen using a different code, such as 36415 for venous blood collection.

8. Historical information

CPT 87551 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 clinician orders CPT 87551 to detect the presence of Mycobacterium species in a patient with a persistent respiratory infection.
2. A lab analyst performs CPT 87551 on a blood specimen to assess the presence of Mycobacterium in a patient with systemic symptoms.
3. A clinician suspects a Mycobacterium infection in a wound and orders CPT 87551 to confirm the diagnosis.
4. A lab analyst uses CPT 87551 to detect the presence of Mycobacterium in a sputum specimen from a patient with suspected tuberculosis.
5. A clinician orders CPT 87551 to detect the presence of Mycobacterium in a patient with leprosy-like symptoms.
6. A lab analyst performs CPT 87551 on a swab specimen to assess the presence of Mycobacterium in a patient with a localized infection.
7. A clinician suspects an atypical cause of infection and orders CPT 87551 to detect the presence of Mycobacterium in a patient with unexplained symptoms.
8. A lab analyst uses CPT 87551 to detect the presence of Mycobacterium in a blood specimen from a patient with suspected disseminated infection.
9. A clinician orders CPT 87551 to detect the presence of Mycobacterium in a sputum specimen from a patient with a chronic cough.
10. A lab analyst performs CPT 87551 on a swab specimen to assess the presence of Mycobacterium in a patient with a skin infection.