How To Use CPT Code 87802

CPT 87802 describes the process of detecting the presence of Streptococcus group B using an immunoassay with direct optical observation. This article will provide an overview of CPT code 87802, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT Code 87802?

CPT 87802 is used to identify the presence of Streptococcus group B through an immunoassay with direct optical observation. This code is specifically for the analysis performed by a lab analyst to detect the bacteria using a visual result, such as a color change or line, indicating a positive result.

2. Official Description

The official description of CPT code 87802 is: ‘Infectious agent antigen detection by immunoassay with direct optical (i.e., visual) observation; Streptococcus, group B.’

3. Procedure

1. The lab analyst performs all the necessary technical steps to analyze the specimen for the presence of Streptococcus group B using an immunoassay.
2. A liquid reagent containing an antibody to group B Streptococcus is mixed with the specimen, typically a swab.
3. The mixture is allowed to react for a specific time interval.
4. The analyst then dispenses the mixture onto a card or other medium that provides a visual result, such as a color change or line, indicating a positive result for Streptococcus group B.

4. Qualifying circumstances

CPT 87802 is typically ordered by clinicians as a screening test for pregnant women or for patients with infections that are not responding to normal antibiotics. Group B streptococci, including Streptococcus agalactiae, can cause various infections, such as pneumonia, meningitis, bone infections, blood infections, or skin infections. The test can be performed on specimens from any source, but it is most commonly done using swabs.

5. When to use CPT code 87802

CPT code 87802 should be used when there is a need to detect the presence of Streptococcus group B using an immunoassay with direct optical observation. It is appropriate to use this code when the lab analyst performs the necessary steps to analyze the specimen and obtains a visual result indicating the presence of Streptococcus group B.

6. Documentation requirements

To support a claim for CPT code 87802, the documentation should include:

• The reason for ordering the test, such as screening for pregnant women or investigating infections not responding to normal antibiotics
• The specific immunoassay technique used
• The date of the test
• The visual result obtained, indicating the presence of Streptococcus group B

7. Billing guidelines

When billing for CPT code 87802, ensure that the test is performed by a lab analyst using an immunoassay with direct optical observation. It is important to note that this code should not be reported with other codes, such as CPT codes 87260-87899, which cover a range of infectious agent antigen detection tests.

8. Historical information

CPT code 87802 was added to the Current Procedural Terminology system on January 1, 2002. The code has undergone a change on October 6, 2020, with an updated description for the detection of Streptococcus group B using immunoassay with direct optical observation.

9. Examples

1. A lab analyst performs an immunoassay with direct optical observation to detect the presence of Streptococcus group B in a swab specimen from a pregnant woman.
2. A clinician orders CPT code 87802 to investigate a persistent infection in a patient that is not responding to standard antibiotics.
3. A lab technician performs an immunoassay with direct optical observation on a swab specimen from an infant with suspected group B streptococcal infection.
4. A physician orders CPT code 87802 to screen a pregnant woman for the presence of Streptococcus group B before delivery.
5. A lab analyst uses an immunoassay with direct optical observation to detect the presence of Streptococcus group B in a swab specimen from a patient with a skin infection.
6. A clinician orders CPT code 87802 to investigate the cause of recurrent pneumonia in an immunocompromised patient.
7. A lab technician performs an immunoassay with direct optical observation on a swab specimen from an elderly patient with suspected group B streptococcal meningitis.
8. A physician orders CPT code 87802 to screen a pregnant woman for the presence of Streptococcus group B during her prenatal check-up.
9. A lab analyst uses an immunoassay with direct optical observation to detect the presence of Streptococcus group B in a swab specimen from a patient with a bone infection.
10. A clinician orders CPT code 87802 to investigate the cause of a recurrent blood infection in a patient with a compromised immune system.