CPT code 87591 bills for service when a physician performs Infectious agent detection by nucleic acid (DNA or RNA), Neisseria gonorrhoeae, and amplified probe technique. Neisseria gonorrhea is one of the most widespread sexually transmitted infections. Molecular (nucleic acid probe) techniques offer rapid, accurate identification of Neisseria gonorrhea. This test may request a gonorrhea amplified DNA probe, gonorrhea molecular probe assay, or DNA detection of gonorrhea.
Description of CPT Code 87591
The official description of CPT 97591 is: “Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique.”
The following are the reasons why the Physician performs CPT code 87591 to detect infections:
- Genital Herpes
- Acquired Immune Deficiency Syndrome (AIDS)
- Hepatitis B (HBV)
- Genital Warts (HPV)
Symptoms may include burning or itching in the penis or vagina, A drip (discharge) from the penis or vagina, pain around the pelvis, Sores, bumps or blisters on the penis or vagina, anus, or mouth, burning and pain with urine or with bowel movements, having to go to the bathroom often.
Amplification can be performed using several techniques. While a cervical or urethral swab is preferred, molecular methods are also sensitive enough to detect the organism in urine. Neisseria gonorrhea can be identified by DNA or rRNA probes.
Ligase chain reaction (LCR) and Polymerase chain reaction (PCR)detect gonorrhea DNA. An Assay is also available, which detects gonorrhea ribosomal RNA (rRNA)
A maximum of one unit can be billed on the same service date of CPT code 87591. In contrast, the three units allow when documentation supports the medical necessity of the service.
The cost of CPT 87591 is $42.84 when performed in the facility. In contrast, the reimbursement of this procedure with modifier 26 is $42.84 when performed in the non-facility.
Investigative agent molecular diagnostic testing using nucleic acid probe reports with CPT codes 87471–87801 and 87901–87904. These CPT codes include all the molecular diagnostic processes. CPT codes 83890–83913 doses are appropriate to report with these CPT codes.
It is appropriate to report comparative tests on culture material (87140-87158) in conjunction with CPT code 87591. Check third-party or payer guidelines if a modifier is required.
If identification antibodies (86602-86804) bill in combination with CPT 87591, it is appropriate to report. Check third-party or payer guidelines if a modifier is required.
It is appropriate to report Nonspecific agent detection (87299, 87449, 87797-87799, 87899) in conjunction with CPT 87591. Check third-party or payer guidelines if a modifier is required.
If Reporting molecular procedure codes as substitutes for codes in this range (81109, 81110, 81111, 81161-81408, 81105, 81106, 81107, 81108, 81112, 81120, 81121, 81161, 81162, 81230, 81231, 81238, 81269, 81283, 81287, 81288, 81334) bills combination with CPT 87591, it is appropriate to report. Check third-party or payer guidelines if a modifier is required.
Modifying 59 with CPT code 87591 is appropriate for additional specimens performed on the same day.
If any evaluation and management service (99201-99499) performs in addition to CPT 87591, It is appropriate to report separately.
Molecular pathology procedures (81200–81408) should not be reported in combination with, or instead of, the infection agent detection by nucleic acid procedures (87471–87801). Gonococcal infections with a duration of two months or more are considered chronic.