Pathology/Lab Coding Alert

Question: Our lab performs an amplified probe infectious agent detection panel for four respiratory viruses: influenza A, influenza B, respiratory syncytial virus, and SARS-CoV-2. The test results show positive or negative for each organism. Should we code the test as 87801?

Iowa Subscriber

Answer: No, you should not code the test you describe using 87801 (Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique). This code describes a single test that provides one result — positive or negative that the specimen contains at least one of the listed organisms, without differentiating or identifying the organism(s).

A more appropriate code would be 87631 (Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets). This test is a true panel in which each pathogen is reported as detected or not detected.

Caution: If you are performing the test using a kit from a specific manufacturer that has a proprietary laboratory analysis (PLA) code for the test, you must report the PLA code. For example, 0241U (Infectious disease (viral respiratory tract infection), pathogen-specific RNA, 4 targets (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], influenza A, influenza B, respiratory syncytial virus [RSV]), upper respiratory specimen, each pathogen reported as detected or not detected) describes the Xpert® Xpress SARS–CoV–2/Flu/ RSV (all targets) test from Cepheid.