How To Use CPT Code 87581

CPT 87581 describes the process of detecting the presence of Mycoplasma pneumoniae, a bacteria, 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 87581?

CPT 87581 can be used to identify the presence of Mycoplasma pneumoniae, a bacteria, through the use of an amplified nucleic acid probe technique. This code is utilized when a lab analyst performs a test on a specimen, typically sputum, blood, or a swab, to assess the presence of the bacteria. The analyst employs amplification techniques, such as polymerase chain reaction (PCR), to increase the number of copies of a specific target nucleic acid sequence. The presence of the amplified nucleic acid sequences is then evaluated using a nucleic acid probe, which is a fabricated single strand sequence of DNA or RNA that binds to the complementary sequence in the specimen through hybridization. The nucleic acid probe is labeled with a radioactive or chemical tag to facilitate visualization of the hybridization product.

2. Official Description

The official description of CPT code 87581 is: ‘Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique.’

3. Procedure

1. The lab analyst receives a specimen, typically sputum, blood, or a swab, for testing.
2. The analyst performs amplification techniques, such as polymerase chain reaction (PCR), to increase the number of copies of a specific target nucleic acid sequence.
3. The amplified nucleic acid sequences are assessed using a nucleic acid probe, which binds to the complementary sequence in the specimen through hybridization.
4. The nucleic acid probe is labeled with a radioactive or chemical tag, allowing the lab analyst to visualize the hybridization product.
5. The presence of Mycoplasma pneumoniae is determined based on the presence of the amplified nucleic acid sequences.

4. Qualifying circumstances

CPT 87581 is used when there is a need to detect the presence of Mycoplasma pneumoniae, a bacteria, in a patient’s specimen. This test is typically performed when there is suspicion of an infection caused by Mycoplasma pneumoniae, such as atypical pneumonia or walking pneumonia. The test is conducted by a lab analyst using an amplified nucleic acid probe technique, which involves amplifying specific target nucleic acid sequences and assessing their presence through hybridization with a nucleic acid probe.

5. When to use CPT code 87581

CPT code 87581 should be used when there is a need to detect the presence of Mycoplasma pneumoniae using an amplified nucleic acid probe technique. This code is appropriate when the lab analyst performs the test on a specimen, such as sputum, blood, or a swab, and assesses the presence of the bacteria through hybridization with a nucleic acid probe. It is important to note that this code is specific to the detection of Mycoplasma pneumoniae and should not be used for other infectious agents.

6. Documentation requirements

To support a claim for CPT code 87581, the following documentation is required:

• Identification of the patient’s specimen and the need for Mycoplasma pneumoniae detection
• Details of the amplified nucleic acid probe technique used, such as polymerase chain reaction (PCR)
• Date and time of the test
• Results of the test indicating the presence or absence of Mycoplasma pneumoniae
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 87581, ensure that the test is performed using an amplified nucleic acid probe technique to detect Mycoplasma pneumoniae. It is important to distinguish between direct probe, amplified probe, and quantification tests for Mycoplasma pneumoniae (CPT codes 87580, 87581, and 87582, respectively). Additionally, consider reporting any separate codes for specimen collection, if applicable. Review payer guidelines for specific billing requirements and modifiers.

8. Historical information

CPT code 87581 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 technique to detect the presence of Mycoplasma pneumoniae in a patient’s sputum sample.
2. Using an amplified nucleic acid probe technique, the lab analyst identifies the presence of Mycoplasma pneumoniae in a blood specimen from a patient with suspected atypical pneumonia.
3. A swab sample from a patient’s respiratory tract is tested by a lab analyst using an amplified nucleic acid probe technique to detect Mycoplasma pneumoniae.