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Old 01-23-2009, 03:05 PM
TracyS TracyS is offline
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Default Rapid RSV Procedure Code

I hope someone can help me with this. I work for a pediatric practice and am having trouble getting BC to pay for procedure code 87807 which we are using for the Rapid RSV (respiratory syncytial virus) test because they consider it a laboratory only test.

They are telling me that they will pay for other tests including procedure 87420 Infectious agent antigen detection by enzyme immunoassay technique, qualitative and quantitative, multiple-step method; adenovirus enteric types 40/41 respiratory synctial virus.

Can I use this procedure instead? If not is there a better code?

Thanks in advance for any help.
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Old 01-23-2009, 03:14 PM
Lisa Bledsoe Lisa Bledsoe is offline
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I think 87807 is the correct code. I'm no expert in Lab coding, but doesn't "direct optical observation" mean it is a rapid test? What codes do you use for rapid strep and rapid flu? (87880 and 87804)? If they cover those why not 87807? Same category just a different infectious agent...

Who DOESN'T have problems with Blue Cross?
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Old 01-28-2009, 08:29 PM
TracyS TracyS is offline
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Lisa,

All our other major insurance carriers are paying for the 87807 and yes we do use 87880 & 87804 for strep & flu.

You're right it is always something with BC.

Thank you for the info.
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