How To Use CPT Code 87800

CPT 87800 describes the process of detecting multiple infectious organisms in a patient’s sample using a direct nucleic acid probe technique. This article will provide an overview of CPT code 87800, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 87800?

CPT 87800 is used to describe the detection of multiple infectious organisms in a patient’s sample using a direct nucleic acid probe technique. This test is performed by a laboratory analyst who assesses the presence of specific nucleic acid sequences that indicate the presence of multiple organisms in the patient’s primary specimen, such as blood. The analyst prepares the specimen and combines it with a nucleic acid probe, which is a fabricated single strand sequence of DNA or RNA. If the complementary sequence is present in the specimen, the probe will hybridize with it, forming a double-stranded molecule. The hybridization product can be visualized using a label attached to the probe, such as a radioactive or chemical tag.

2. Official Description

The official description of CPT code 87800 is: ‘Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique.’

3. Procedure

1. The laboratory analyst receives the patient’s sample, such as blood, for testing.
2. The analyst prepares the specimen and combines it with a nucleic acid probe, which is a fabricated single strand sequence of DNA or RNA.
3. If the specimen contains the complementary sequence to the probe, the probe will hybridize with it, forming a double-stranded molecule.
4. The hybridization product is visualized using a label attached to the probe, such as a radioactive or chemical tag.
5. The analyst interprets the results and reports the presence or absence of specific nucleic acid sequences indicating the presence of multiple infectious organisms in the patient’s sample.

4. Qualifying circumstances

CPT 87800 is used when a patient is suspected of having an infection caused by more than one infectious organism. The test is performed by a laboratory analyst who assesses the presence of specific nucleic acid sequences indicating the presence of multiple organisms in the patient’s sample. The test is not limited to any specific condition and can be ordered by clinicians when necessary.

5. When to use CPT code 87800

CPT code 87800 should be used when a direct nucleic acid probe technique is employed to detect multiple infectious organisms in a patient’s sample. It is important to distinguish between CPT code 87800 and CPT code 87801, which is used for amplified probe tests for multiple organisms. If the laboratory uses a test that screens for more than one organism at once using the direct probe technique, CPT code 87800 should be reported instead of individual codes for each organism. However, some payers may separately reimburse for specimen collection using a code such as 36415 for venous blood collection.

6. Documentation requirements

To support a claim for CPT code 87800, the laboratory analyst must document the following information:

• Patient’s specimen type and source
• Specific nucleic acid probe used for the test
• Date and time of the test
• Results indicating the presence or absence of specific nucleic acid sequences indicating the presence of multiple infectious organisms
• Signature of the laboratory analyst performing the test

7. Billing guidelines

When billing for CPT code 87800, ensure that the test is performed using a direct nucleic acid probe technique to detect multiple infectious organisms. It is important to follow the specific guidelines provided by payers regarding reimbursement for specimen collection. Additionally, it is crucial to distinguish between CPT code 87800 and CPT code 87801 for amplified probe tests.

8. Historical information

CPT code 87800 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates or changes to the code since its addition.

9. Examples

1. A laboratory analyst performs a direct nucleic acid probe test on a patient’s blood sample to detect the presence of multiple infectious organisms.
2. A clinician suspects a patient has a respiratory infection caused by more than one organism and orders a direct nucleic acid probe test using CPT code 87800.
3. A laboratory analyst uses a direct nucleic acid probe technique to detect multiple infectious organisms in a patient’s cerebrospinal fluid sample.
4. A patient presents with symptoms of a gastrointestinal infection, and a direct nucleic acid probe test is performed to identify the presence of multiple organisms.
5. A laboratory analyst performs a direct nucleic acid probe test on a patient’s urine sample to detect the presence of multiple infectious organisms.
6. A clinician suspects a patient has a bloodstream infection caused by multiple organisms and orders a direct nucleic acid probe test using CPT code 87800.
7. A laboratory analyst uses a direct nucleic acid probe technique to detect multiple infectious organisms in a patient’s wound swab sample.
8. A patient with symptoms of a sexually transmitted infection undergoes a direct nucleic acid probe test to identify the presence of multiple organisms.
9. A laboratory analyst performs a direct nucleic acid probe test on a patient’s respiratory secretions to detect the presence of multiple infectious organisms.
10. A clinician suspects a patient has an infection in their joint fluid caused by more than one organism and orders a direct nucleic acid probe test using CPT code 87800.