How To Use CPT Code 87910

CPT 87910 describes the analysis of the genotype of cytomegalovirus (CMV) using nucleic acid testing. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 87910?

CPT 87910 can be used to describe the analysis of the genotype of cytomegalovirus (CMV) using nucleic acid testing. This code is used when a lab analyst performs the technical steps to detect the genotype of CMV by multiplying the amount of DNA or RNA in the sample and analyzing the sequence to determine if the virus has mutated, making it resistant to particular drugs.

2. Official Description

The official description of CPT code 87910 is: ‘Infectious agent genotype analysis by nucleic acid (DNA or RNA); cytomegalovirus.’

3. Procedure

1. The lab analyst performs all technical steps to detect the genotype of cytomegalovirus by nucleic acid testing.
2. The specimen, most often serum, is collected and prepared for analysis.
3. The lab analyst uses polymerase chain reaction (PCR) to multiply the amount of DNA or RNA in the sample.
4. The lab analyst joins the nucleic acid with fragments of the DNA or RNA in the standard, labeled with a tag that allows for the determination of the DNA or RNA sequencing of the CMV.
5. By analyzing the sequence, the lab analyst can determine if the virus has mutated, making it resistant to particular drugs.

4. Qualifying circumstances

CPT 87910 is typically ordered when a patient with a known CMV infection is showing resistance to therapy. It may also be ordered on pregnant patients and immunocompromised patients with serious infections.

5. When to use CPT code 87910

CPT code 87910 should be used when there is a need to analyze the genotype of cytomegalovirus using nucleic acid testing. It is important to ensure that the test is specifically for drug resistance genotyping of CMV.

6. Documentation requirements

To support a claim for CPT 87910, the documentation should include:

• Reason for ordering the test, such as resistance to therapy or high-risk patient population
• Details of the specimen collected and tested
• Method used for nucleic acid testing, such as PCR
• Results of the genotype analysis and any mutations detected
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 87910, ensure that the test is specifically for drug resistance genotyping of CMV. It is important to use the appropriate codes for other CMV-related tests, such as direct fluorescence, multiple step enzyme immunoassay, nucleic acid detection, or antibody immunoassays. Some payers may also separately reimburse for specimen collection using a specific code.

8. Historical information

CPT 87910 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A patient with a known CMV infection is showing resistance to antiviral therapy. CPT code 87910 is used to analyze the genotype of CMV to determine if the virus has mutated, making it resistant to the prescribed drugs.
2. A pregnant patient with a suspected CMV infection undergoes nucleic acid testing using CPT code 87910 to assess the risk of transmission to the fetus.
3. An immunocompromised patient with severe CMV infection undergoes genotype analysis using CPT code 87910 to guide treatment decisions.
4. A patient with CMV infection is not responding to standard therapy. CPT code 87910 is used to analyze the genotype of the virus and identify any drug-resistant mutations.
5. A patient with a history of CMV infection and recurrent symptoms undergoes nucleic acid testing using CPT code 87910 to assess the presence of drug-resistant strains.
6. A clinician suspects CMV drug resistance in a patient and orders genotype analysis using CPT code 87910 to guide treatment decisions.
7. A patient with CMV infection is being considered for a change in antiviral therapy. CPT code 87910 is used to analyze the genotype of the virus and determine the most appropriate treatment options.
8. An immunocompromised patient with CMV infection undergoes nucleic acid testing using CPT code 87910 to monitor the presence of drug-resistant strains over time.
9. A patient with CMV infection is enrolled in a clinical trial for new antiviral drugs. CPT code 87910 is used to analyze the genotype of the virus and assess its susceptibility to the experimental treatments.
10. A patient with CMV infection is being evaluated for potential organ transplantation. CPT code 87910 is used to assess the presence of drug-resistant strains that may impact the choice of immunosuppressive therapy.