How To Use CPT Code 87556

CPT 87556 describes the detection of Mycobacterium tuberculosis 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 87556?

CPT 87556 can be used to detect the presence of Mycobacterium tuberculosis using an amplified nucleic acid probe technique. This code is used when a lab analyst performs a test on a specimen, commonly sputum, to assess the presence of the bacterium. The test involves amplification techniques, such as 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, a fabricated single strand sequence of DNA or RNA, to identify the presence of Mycobacterium tuberculosis through a process called hybridization.

2. Official Description

The official description of CPT code 87556 is: ‘Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, amplified probe technique.’

3. Procedure

1. The lab analyst receives a specimen, such as sputum, blood, biopsies, or fluids from the body, for testing.
2. The lab analyst performs amplification techniques, such as PCR, to increase the number of copies of the target nucleic acid sequence.
3. The lab analyst assesses the presence of Mycobacterium tuberculosis by using a nucleic acid probe that binds to the complementary sequence in the specimen through hybridization.
4. The lab analyst visualizes the hybridization product using a label, such as a radioactive or chemical tag, attached to the nucleic acid probe.
5. The lab analyst interprets the results to determine the presence or absence of Mycobacterium tuberculosis in the specimen.

4. Qualifying circumstances

CPT 87556 is used when there is a need to detect the presence of Mycobacterium tuberculosis in a specimen. This test is commonly performed when a patient presents with signs and symptoms of tuberculosis or other infections caused by Mycobacterium tuberculosis. The specimen can be obtained from various sources, such as sputum, blood, biopsies, or fluids from the body. The test is performed by a lab analyst using an amplified nucleic acid probe technique.

5. When to use CPT code 87556

CPT code 87556 should be used when there is a need to detect the presence of Mycobacterium tuberculosis in a specimen using an amplified nucleic acid probe technique. This code is appropriate when the lab analyst performs the test and interprets the results to determine the presence or absence of the bacterium. It is important to note that CPT code 87556 should not be reported for direct probe, quantification, or other related tests for Mycobacterium tuberculosis.

6. Documentation requirements

To support a claim for CPT code 87556, the following documentation is required:

• Specimen source and type
• Details of the amplification techniques used, such as PCR
• Description of the nucleic acid probe used
• Date and time of the test
• Interpretation of the results indicating the presence or absence of Mycobacterium tuberculosis
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 87556, ensure that the test is performed using an amplified nucleic acid probe technique to detect Mycobacterium tuberculosis. It is important to distinguish this code from other related codes, such as direct probe or quantification tests for Mycobacterium tuberculosis. Additionally, consider any specific billing guidelines provided by payers regarding the use of CPT code 87556. It is also important to note that some payers may separately reimburse for specimen collection using a different code.

8. Historical information

CPT code 87556 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 an amplified nucleic acid probe test on a sputum specimen to detect the presence of Mycobacterium tuberculosis.
2. A patient presents with symptoms of tuberculosis, and a lab analyst performs an amplified nucleic acid probe test on a blood sample to confirm the diagnosis.
3. A lab analyst processes a biopsy specimen and performs an amplified nucleic acid probe test to assess the presence of Mycobacterium tuberculosis in the tissue.
4. A patient with suspected tuberculosis undergoes a bronchoalveolar lavage, and a lab analyst performs an amplified nucleic acid probe test on the fluid sample to detect the bacterium.
5. A lab analyst performs an amplified nucleic acid probe test on a cerebrospinal fluid sample to assess the presence of Mycobacterium tuberculosis in a patient with suspected central nervous system infection.
6. A patient with a history of tuberculosis presents with symptoms of recurrent infection, and a lab analyst performs an amplified nucleic acid probe test on a sputum specimen to determine if the bacterium is still present.
7. A lab analyst performs an amplified nucleic acid probe test on a pleural fluid sample to detect the presence of Mycobacterium tuberculosis in a patient with suspected pleural infection.
8. A patient with suspected tuberculosis undergoes a lymph node biopsy, and a lab analyst performs an amplified nucleic acid probe test on the tissue sample to confirm the diagnosis.
9. A lab analyst performs an amplified nucleic acid probe test on a urine sample to assess the presence of Mycobacterium tuberculosis in a patient with suspected urinary tract infection.