How To Use CPT Code 87563

CPT 87563 describes the detection of Mycoplasma genitalium antigen in patient specimens 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 87563?

CPT 87563 can be used to detect the presence of Mycoplasma genitalium antigen in patient specimens using an amplified nucleic acid probe technique. This code is used when the lab analyst performs a test on a patient specimen, such as blood, to assess the presence of Mycoplasma genitalium infection. 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 to detect the amplified nucleic acid sequences indicating the presence of Mycoplasma genitalium infection.

2. Official Description

The official description of CPT code 87563 is: ‘Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma genitalium, amplified probe technique.’

3. Procedure

1. The lab analyst processes the patient specimen, such as blood, and performs amplification techniques, such as polymerase chain reaction (PCR), to increase the number of copies of a specific target nucleic acid sequence.
2. 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 a process called hybridization.
3. The nucleic acid probe includes a label, such as a radioactive or chemical tag, that allows the lab analyst to visualize the hybridization product.
4. The lab analyst assesses the presence of the amplified nucleic acid sequences indicating Mycoplasma genitalium infection.

4. Qualifying circumstances

CPT 87563 is used to detect Mycoplasma genitalium antigen in patient specimens. Clinicians typically order this test to help diagnose Mycoplasma genitalium infection, which is a sexually transmitted infection (STI). Symptoms of Mycoplasma genitalium infection may include burning on urination, vaginal itching and discharge in women, or urethral discharge in men.

5. When to use CPT code 87563

CPT code 87563 should be used when there is a need to detect Mycoplasma genitalium antigen in patient specimens. It is appropriate to bill this code when the lab analyst performs the amplified probe technique to assess the presence of Mycoplasma genitalium infection. This code should not be used for testing other infectious agents or for non-Mycoplasma genitalium related purposes.

6. Documentation requirements

To support a claim for CPT 87563, the documentation should include:

• Indication for testing and the need to detect Mycoplasma genitalium antigen
• Details of the amplified probe technique used, such as PCR
• Date and time of the test
• Results of the test indicating the presence or absence of Mycoplasma genitalium antigen
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 87563, ensure that the test is performed to detect Mycoplasma genitalium antigen using an amplified nucleic acid probe technique. It is important to follow the specific guidelines provided by the payer regarding documentation and any additional requirements for reimbursement. Some payers may also separately reimburse for specimen collection using a different code.

8. Historical information

CPT 87563 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performing a test on a patient’s blood specimen to detect Mycoplasma genitalium antigen using an amplified nucleic acid probe technique.
2. A clinician ordering CPT 87563 to help diagnose Mycoplasma genitalium infection in a patient presenting with symptoms of a sexually transmitted infection.
3. A lab analyst using PCR to amplify the nucleic acid sequences of Mycoplasma genitalium in a patient specimen and then detecting the presence of the amplified sequences using a nucleic acid probe.
4. A patient undergoing CPT 87563 testing to confirm the presence of Mycoplasma genitalium infection after experiencing symptoms such as burning on urination and vaginal itching.
5. A lab analyst visualizing the hybridization product of the nucleic acid probe with the amplified Mycoplasma genitalium sequences, indicating the presence of the infection.
6. A clinician ordering CPT 87563 to rule out Mycoplasma genitalium infection in a patient with symptoms suggestive of a sexually transmitted infection.
7. A lab analyst performing the amplified probe technique on a patient’s specimen to detect Mycoplasma genitalium antigen and provide a diagnosis for appropriate treatment.
8. A patient receiving CPT 87563 testing to confirm the presence of Mycoplasma genitalium infection after experiencing symptoms such as urethral discharge.
9. A lab analyst using an amplified nucleic acid probe technique to detect Mycoplasma genitalium antigen in a patient’s specimen and provide accurate results for further management.
10. A clinician ordering CPT 87563 to assess the presence of Mycoplasma genitalium infection in a patient with symptoms of a sexually transmitted infection, such as vaginal discharge.