How To Use CPT Code 87640

CPT 87640 pertains to the detection of infectious agents through nucleic acid testing, specifically targeting Staphylococcus aureus using an amplified probe technique. This advanced laboratory procedure is crucial for diagnosing infections caused by this common bacterium, which can affect various parts of the body. The amplified probe technique enhances the sensitivity and specificity of the test, allowing for the rapid identification of Staphylococcus aureus, including its methicillin-resistant strain (MRSA), which poses significant treatment challenges due to its resistance to standard antibiotics.

1. What is CPT code 87640?

CPT code 87640 represents a laboratory test that detects the presence of Staphylococcus aureus nucleic acid (DNA or RNA) using an amplified probe technique. This code is essential in the field of microbiology and infectious disease diagnostics, as it allows healthcare providers to identify infections caused by this bacterium quickly and accurately. Staphylococcus aureus is a common pathogen associated with a range of infections, from minor skin infections to severe conditions such as pneumonia and sepsis. The amplified probe technique, which includes methods like polymerase chain reaction (PCR), significantly increases the test’s sensitivity, enabling the detection of even low levels of bacterial nucleic acid in various specimen types.

2. Qualifying Circumstances

This CPT code can be utilized when there is a clinical suspicion of an infection caused by Staphylococcus aureus. It is particularly relevant in cases where traditional culture methods may be insufficient or too slow to provide timely results. The use of this code is appropriate when specimens are collected from various sources, including sputum, wound swabs, vaginal swabs, or nasal swabs. However, it is important to note that this code should not be used for non-specific tests or when the clinical context does not support the suspicion of Staphylococcus aureus infection. Additionally, if the specimen is not suitable for nucleic acid testing or if the testing does not specifically target Staphylococcus aureus, this code would not be applicable.

3. When To Use CPT 87640

CPT 87640 is used when a healthcare provider orders a laboratory test to detect Staphylococcus aureus in a patient suspected of having an infection. This code is particularly relevant in acute care settings where rapid diagnosis is critical. It can be used in conjunction with other codes for related services, such as specimen collection, but should not be reported alongside codes for other infectious agents unless specifically indicated. The use of this code is restricted to instances where the amplified probe technique is employed, ensuring that the test’s methodology aligns with the code’s description.

4. Official Description of CPT 87640

Official Descriptor: Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, amplified probe technique.

5. Clinical Application

CPT 87640 is applied in clinical settings to diagnose infections caused by Staphylococcus aureus, which can lead to serious health complications if not identified and treated promptly. The test is particularly valuable in cases of suspected MRSA infections, where timely identification can influence treatment decisions and improve patient outcomes. The amplified probe technique enhances the detection capabilities of the laboratory, allowing for quicker results compared to traditional culture methods. This rapid identification is crucial in managing infections effectively, especially in hospital settings where antibiotic resistance is a growing concern.

5.1 Provider Responsibilities

The provider’s responsibilities during the procedure include collecting the appropriate specimen from the patient, ensuring that it is suitable for nucleic acid testing. Once the specimen is obtained, the lab analyst performs all technical steps necessary for analysis. This includes preparing the specimen, applying amplification techniques such as PCR to increase the quantity of Staphylococcus aureus nucleic acid, and utilizing a nucleic acid probe to detect the presence of the target organism. The analyst must also interpret the results accurately, ensuring that any findings are communicated effectively to the healthcare provider for further action.

5.2 Unique Challenges

One of the unique challenges associated with this service is the potential for contamination during specimen collection and processing, which can lead to false-positive results. Additionally, the complexity of the amplification techniques requires skilled personnel and specialized equipment, which may not be available in all laboratory settings. The rapid nature of the test also necessitates that the laboratory maintain stringent quality control measures to ensure the accuracy and reliability of results. Furthermore, interpreting the results in the context of the patient’s clinical picture is essential, as positive findings may not always indicate an active infection.

5.3 Pre-Procedure Preparations

Before performing the test, the provider must ensure that the specimen is collected correctly and is appropriate for nucleic acid testing. This may involve instructing the patient on how to provide a suitable sample, such as a nasal swab or wound swab. The laboratory must also prepare the necessary reagents and equipment for the amplification process, ensuring that all materials are ready for use to minimize delays in testing. Proper labeling and documentation of the specimen are crucial to avoid mix-ups and ensure accurate tracking of results.

5.4 Post-Procedure Considerations

After the procedure, the lab analyst must carefully analyze the results and document findings in the patient’s medical record. Follow-up may be required to discuss the results with the healthcare provider, especially if the test indicates the presence of Staphylococcus aureus or MRSA. The provider may need to adjust the patient’s treatment plan based on the test results, which could include initiating or changing antibiotic therapy. Monitoring the patient for clinical improvement or deterioration is also essential, as timely intervention can significantly impact patient outcomes.

6. Relevant Terminology

Amplification: The process of making multiple copies of a specific DNA or RNA sequence to enhance detection capabilities in laboratory testing.

Hybridization: A technique in molecular biology where two complementary strands of nucleic acid bind together to form a double-stranded molecule, allowing for the detection of specific sequences.

Nucleic acid: The genetic material of organisms, consisting of DNA or RNA, which carries the instructions for biological functions.

7. Clinical Examples

1. A patient presents with a skin abscess, and the healthcare provider orders a test to determine if Staphylococcus aureus is the causative agent.

2. A patient with pneumonia is suspected of having a MRSA infection, prompting the clinician to request nucleic acid testing for rapid diagnosis.

3. A wound swab is collected from a diabetic patient with a non-healing ulcer, and the provider orders a test to check for Staphylococcus aureus.

4. A healthcare facility experiences an outbreak of skin infections, leading to the decision to test multiple patients for Staphylococcus aureus using nucleic acid detection.

5. A patient undergoing surgery develops a postoperative infection, and the surgeon orders a rapid test to identify the presence of Staphylococcus aureus.

6. A child with recurrent ear infections is tested for Staphylococcus aureus to determine if it is contributing to the ongoing issue.

7. A patient with a history of MRSA infections presents with a new abscess, and the provider orders nucleic acid testing to confirm the diagnosis.

8. A healthcare provider suspects a Staphylococcus aureus infection in a patient with fever and chills, leading to the ordering of a rapid nucleic acid test.

9. A laboratory receives a nasal swab from a patient with respiratory symptoms, and the clinician requests testing for Staphylococcus aureus to rule out infection.

10. A patient with a history of skin infections is tested for Staphylococcus aureus prior to starting a new immunosuppressive therapy.