How To Use CPT Code 87809

CPT 87809 describes the process of infectious agent antigen detection by immunoassay with direct optical observation for adenovirus. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 87809?

CPT 87809 can be used to detect the presence of adenovirus antigen through immunoassay with direct optical observation. This code is specifically used for the analysis of adenovirus antigen using a visual method. The test is performed by a lab analyst who mixes the patient’s specimen, such as a nasal or throat swab, with a liquid reagent containing an antibody to adenovirus. The reaction is then observed visually on a card, which will indicate a positive result through a color change or the appearance of a line.

2. Official Description

The official description of CPT code 87809 is: ‘Infectious agent antigen detection by immunoassay with direct optical (i.e., visual) observation; adenovirus.’

3. Procedure

1. The lab analyst receives the patient’s specimen, which is commonly a nasal or throat swab.
2. The analyst mixes the specimen with a liquid reagent containing an antibody to adenovirus.
3. A time interval is allowed for the antibody-antigen reaction to occur.
4. The analyst dispenses the mixture onto a card that provides a visual result.
5. The visual result, such as a color change or the appearance of a line, indicates the presence of adenovirus antigen.

4. Qualifying circumstances

CPT 87809 is used when there is a need to detect the presence of adenovirus antigen in a patient’s specimen. Adenovirus is a common virus that can cause respiratory illness, eye infections, and other infections. The test can aid in the diagnosis of respiratory conditions, eye inflammation (conjunctivitis), or other conditions associated with adenovirus infection. The specimen can be from any source, but it is most commonly a nasal or throat swab. In more severe cases, serum or cerebrospinal fluid may be used as the specimen.

5. When to use CPT code 87809

CPT code 87809 should be used when there is a clinical need to detect the presence of adenovirus antigen in a patient’s specimen. It is appropriate to use this code when performing the immunoassay with direct optical observation method specifically for adenovirus detection. However, it is important to note that this code is not limited to testing for a specific condition and can be used in various clinical scenarios where adenovirus infection is suspected.

6. Documentation requirements

To support a claim for CPT 87809, the following documentation is required:

• Patient’s diagnosis or suspected condition warranting the adenovirus antigen detection
• Details of the specimen used for the test (e.g., nasal swab, throat swab, serum, cerebrospinal fluid)
• Date and time of the test
• Results of the visual observation, including any color changes or appearance of lines
• Signature of the lab analyst who performed the test

7. Billing guidelines

When billing for CPT 87809, ensure that the test is performed by a lab analyst using the immunoassay with direct optical observation method specifically for adenovirus detection. It is important to follow the specific guidelines provided by payers regarding the use of modifiers or reporting of additional codes for specimen collection. It is also essential to review any local coverage determinations or policies that may affect reimbursement for this test.

8. Historical information

CPT 87809 was added to the Current Procedural Terminology system on January 1, 2008. Since its addition, there have been no updates or changes to the code.

9. Examples

1. A lab analyst performs an immunoassay with direct optical observation to detect adenovirus antigen in a nasal swab specimen.
2. Using the immunoassay method, a lab analyst visually observes a color change on a card, indicating the presence of adenovirus antigen in a throat swab specimen.
3. During the immunoassay process, a lab analyst detects the appearance of a line on a card, confirming the presence of adenovirus antigen in a serum specimen.
4. By performing the immunoassay with direct optical observation, a lab analyst identifies a color change on a card, indicating the presence of adenovirus antigen in a cerebrospinal fluid specimen.
5. Using the immunoassay method, a lab analyst visually observes the appearance of a line on a card, confirming the presence of adenovirus antigen in a nasal swab specimen.
6. A lab analyst performs the immunoassay with direct optical observation and detects a color change on a card, indicating the presence of adenovirus antigen in a throat swab specimen.
7. During the immunoassay process, a lab analyst identifies the appearance of a line on a card, confirming the presence of adenovirus antigen in a serum specimen.
8. By performing the immunoassay with direct optical observation, a lab analyst visually observes a color change on a card, indicating the presence of adenovirus antigen in a cerebrospinal fluid specimen.
9. Using the immunoassay method, a lab analyst detects the appearance of a line on a card, confirming the presence of adenovirus antigen in a nasal swab specimen.
10. A lab analyst performs the immunoassay with direct optical observation and visually observes a color change on a card, indicating the presence of adenovirus antigen in a throat swab specimen.