Eliminate the Confusion of Streptoccal Detection Codes
Published on Sat Apr 01, 2000
Coding for streptococcal detection methods can be confusing, with multiple references scattered through CPTs immunology and microbiology sections. The deletion of 86588 (streptococcus, screen, direct) in CPT Codes 2000 seems to have added to the confusion for some. But with a better understanding of the reasons for the different tests and the methods involved in conducting them, correct coding for streptococcus detection can enhance both compliance and reimbursement.
Code 86588, which many labs were using to report rapid strep screens, was deleted in CPT 2000 to end duplicate reporting with the other strep detection processes. To report the deleted code, according to CPT direction, see 86403,87081, 87430, or 87880.
86403particle agglutination; screen, each antibody
87081culture, bacterial, screening only, for single
organisms
87430 infectious agent antigen detection by
enzyme immunoassay technique, qualitative or
semiquantitative, multiple step method; streptococcus
group A
87880infectious agent detection by immunoassay
with direct optical observation; streptococcus,
group A
The reference to the different codes means that strep screening should be coded according to the methodology of the specific test being used, states Stan Werner, MT (ASCP) administrative director and corporate compliance officer of Peterson Clinical Laboratory in Manhattan, Kan. Theres a wide range of lab methods to detect streptococcal infections, including antibody or antigen screens using particle agglutination, culturing, enzyme immunoassay (EIA), or direct optical observation.
Rapid Strep Screens
Most rapid strep screens will be reported using code 87880, Werner advises. This concurs with Health Care Financing Administration (HCFA) program memorandum AB-99-84, which states: Effective for 2000, deletion of CPT code 86588 should be replaced with the use of code 87880. There are many different commercial tests on the market that would be coded 87880, says Werner. These tests may use different methods of EIA, but their common feature is that the endpoint is some type of visual result, such as a specific color change. This direct optical observation indicates the presence or absence of the streptococcus group A organism.
The rapid strep screens are common, easy-to-perform tests, states Mary Jo Bonifas, MT (ASCP), laboratory manager at United Clinical Laboratories in Dubuque, Iowa. One of these quick, visual detection methods typically is used at a physician office lab to determine if a sore throat is due to a streptococcal group A infection.
In fact, many of the rapid strep tests are approved for laboratories that are granted waived status under the Clinical Laboratory Improvement Amendments (CLIA) standards. A lab that [...]
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