Pathology/Lab Coding Alert

Reader Questions:

Report Most Specific Lab Method

Question: Our lab runs an amplified-probe nucleic-acid Streptococcus group B detection test, but lately we-ve been getting denials when we use 87798. What is the proper code for the test?

Utah Subscriber  Answer: CPT 2007 added a new, specific code for Streptococcus group B using the method you describe -- 87653 (Streptococcus, group B, amplified probe technique). Before the advent of this code, labs used the less-specific code 87798 (Infectious agent detection by nucleic acid [DNA or RNA], not otherwise specified; amplified probe technique, each organism).

Don't forget: Tests to identify infectious agents are method-specific. Your lab might use other methods to identify Streptococcus group B, and you would report a different code based on the method, such as 87802 (Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group B).

You-ll find even more method choices for some organisms, such as Streptococcus group A, which you might report with any of the following codes:
 
- 87650 -- Infectious agent detection by nucleic acid  (DNA or RNA); Streptococcus, group A, direct probe technique

- 87651 -- ... Streptococcus, group A, amplified probe technique 

- 87652 -- ... Streptococcus, group A, quantification

- 87880 -- Infectious agent detection by immunoassay with direct optical observation; Streptococcus, group A

- 87430 -- Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method;
 Streptococcus, group A.
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