How To Use CPT Code 87557

CPT 87557 describes the quantification of infection with Mycobacterium tuberculosis 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 87557?

CPT 87557 can be used to quantify the infection with Mycobacterium tuberculosis using nucleic acid probe technique. This code is used when the lab analyst performs a test to assess the presence of Mycobacterium tuberculosis in a specimen, such as sputum, blood, body fluids, or biopsy. 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 evaluates the amplified nucleic acid sequences using a nucleic acid probe to determine the presence and quantity of Mycobacterium tuberculosis.

2. Official Description

The official description of CPT code 87557 is: ‘Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification.’

3. Procedure

1. The lab analyst processes the specimen, typically sputum, blood, body fluids, or biopsy, to extract the nucleic acid.
2. Amplification techniques, such as polymerase chain reaction (PCR), are performed to increase the number of copies of the target nucleic acid sequence.
3. The lab analyst evaluates the amplified nucleic acid sequences using a nucleic acid probe specific to Mycobacterium tuberculosis.
4. The nucleic acid probe binds to the complementary sequence in the specimen through hybridization, forming a double-stranded DNA or RNA molecule.
5. The lab analyst visualizes and quantifies the hybridization product, which indicates the presence and quantity of Mycobacterium tuberculosis.

4. Qualifying circumstances

CPT 87557 is used for the quantification of Mycobacterium tuberculosis infection. This test is typically performed to assess the efficacy of treatment by comparing the baseline quantification with subsequent quantifications after the patient has been on treatment for a period of time. It is not limited to testing for tuberculosis but can also be used to detect Mycobacterium tuberculosis infections in other parts of the body, such as the brain, spine, joints, heart, liver, or kidneys.

5. When to use CPT code 87557

CPT code 87557 should be used when quantifying the infection with Mycobacterium tuberculosis using nucleic acid probe technique. It is appropriate to bill this code when the lab analyst performs the test and evaluates the amplified nucleic acid sequences to determine the presence and quantity of Mycobacterium tuberculosis. This code should not be used for other types of infectious agent detection or for non-quantitative assessments of Mycobacterium tuberculosis infection.

6. Documentation requirements

To support a claim for CPT 87557, the documentation should include:

• Identification of the specimen source (e.g., sputum, blood, body fluids, biopsy)
• Description of the amplification techniques used, such as polymerase chain reaction (PCR)
• Details of the nucleic acid probe specific to Mycobacterium tuberculosis
• Date of the test and the quantification results
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 87557, ensure that the test is performed to quantify the infection with Mycobacterium tuberculosis using nucleic acid probe technique. It should not be reported with other codes for direct probe or amplified probe tests for Mycobacterium tuberculosis. It is important to distinguish between CPT codes 87555, 87556, and 87557 for different types of tests related to Mycobacterium tuberculosis. Some payers may also separately reimburse for specimen collection using a code such as 36415 for venous blood collection.

8. Historical information

CPT 87557 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 quantification test for Mycobacterium tuberculosis using nucleic acid probe technique on a sputum specimen.
2. A patient with suspected tuberculosis undergoes a blood test for quantification of Mycobacterium tuberculosis infection using nucleic acid probe technique.
3. A lab analyst evaluates the amplified nucleic acid sequences from a biopsy specimen to determine the quantity of Mycobacterium tuberculosis present.
4. After a patient has been on tuberculosis treatment for several weeks, a follow-up quantification test using nucleic acid probe technique is performed to assess the efficacy of the treatment.
5. A lab analyst quantifies the Mycobacterium tuberculosis infection in a body fluid specimen using nucleic acid probe technique to guide the management of the patient’s condition.
6. A sputum specimen from a patient with suspected tuberculosis is tested for quantification of Mycobacterium tuberculosis using nucleic acid probe technique to aid in the diagnosis and treatment of the infection.
7. A lab analyst performs a quantification test for Mycobacterium tuberculosis using nucleic acid probe technique on a biopsy specimen from a patient with extrapulmonary tuberculosis.
8. After initiating treatment for tuberculosis, a patient undergoes a follow-up quantification test using nucleic acid probe technique to monitor the response to treatment and adjust the management plan if necessary.
9. A blood specimen from a patient with suspected disseminated tuberculosis is tested for quantification of Mycobacterium tuberculosis using nucleic acid probe technique to assess the extent of the infection.
10. A lab analyst quantifies the Mycobacterium tuberculosis infection in a body fluid specimen using nucleic acid probe technique to guide the selection of appropriate antimicrobial therapy.