Report CPT 87635 for laboratory blood testing for diagnosing COVID-19 by detecting the SARS-CoV-2 virus.
What Is CPT Code 87635?
CPT code 87635 is used to report the laboratory testing of a patient’s blood to detect antibodies to the SARS-CoV-2 virus, which causes COVID-19.
CPT 87635 is used to report the laboratory testing of a patient’s blood to determine if they have been infected with the SARS-CoV-2 virus in the past or if they have developed immunity to the virus as a result of being vaccinated.
The CPT code 87635 is used to report the laboratory testing of a patient’s blood for detecting SARS-CoV-2 antibodies using methods such as enzyme-linked immunosorbent assay (ELISA) or rapid antigen tests.
Providers typically order these tests to help diagnose or monitor the progress of COVID-19 in patients or to determine if an individual has immunity to the virus.
The CPT book describes CPT 87635 as: “Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), amplified probe technique.”
The lab analyst processes the specimen from a source such as a throat swab, sputum, or respiratory secretions and performs amplification techniques, such as polymerase chain reaction (PCR), that results in a millionfold increase in the number of copies of a specific target nucleic acid sequence.
The lab analyst then assesses the presence of the amplified nucleic acid sequences that indicate the presence of the SARS–CoV–2 virus using a nucleic acid probe, which is a fabricated single–strand sequence of DNA or RNA used to join with the complementary sequence in the specimen through a process called hybridization.
The nucleic acid probe includes a label, such as a radioactive or chemical tag, that allows the lab analyst to visualize the hybridization product.
Although not limited to testing for a specific condition, clinicians may order this test to diagnose infection with the virus that causes a severe acute respiratory syndrome (SARS) related disease called Coronavirus disease (COVID–19) in patients with symptoms of a respiratory infection.
How To Use CPT 87635
Suppose the lab performs reverse transcription, in which a nucleotide sequence is copied from an RNA template during DNA synthesis. In that case, that service is also included, and you should not bill it separately.
For testing for SARS–CoV–2 antibodies, see CPT 86328 for a single–step immunoassay using a reagent strip, such as might be used for point–of–care testing, and see CPT 86769 for the multistep method.
CMS has also created new codes for laboratory testing of the SARS–CoV–2 viruses; CPT U0001 is specifically for the CDC–developed kit, and CPT U0002 is for tests created by other labs.
CPT 86769 is a CLIA-waived test.