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Wiki rapid flu test

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ayen61

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I need help billing rapid flu test, this is for Influenza A & B. I'm looking at cpt code 87275,87276 and 87400. How can I code them correctly. Appreciate any help. Thanks
 
It depends on your method...

Direct optical observation =

The appropriate code to report is code 87804, Infectious agent antigen detection by immunoassay with direct optical observation; Influenza. For code 87804, a respiratory sample (eg, throat swab, nasopharyngeal swab, nasal aspirate, sputum) is obtained to perform the rapid test.

Code 87804 is reported twice because two separate, distinct analyses are performed, providing two separate test results, one for influenza virus A and one for influenza virus B, even if it was one test kit. Certain payers may require the use of modifier 59 when the same CPT code is used; alternatively, the payer may require use of the units box on the claim form.
 
Definative answer from binax

ayen said:
I need help billing rapid flu test, this is for Influenza A & B. I'm looking at cpt code 87275,87276 and 87400. How can I code them correctly. Appreciate any help. Thanks
Click to expand...

Okay, I went to the source to get a definative answer about how to code the rapid flu test A/B. This is how it is done;
(87804 is with visual confirmation, and is the correct code for the quick A/B flu test per Binax)
87804QW & 8780459QW.
The QW on the first one is, of course for clia waved and the 59 on the second one is to show it was done more than once and the second one still needs the QW to show clia waved. ja
 
Last edited:
rebeccawoodward said:
It depends on your method...

Direct optical observation =

The appropriate code to report is code 87804, Infectious agent antigen detection by immunoassay with direct optical observation; Influenza. For code 87804, a respiratory sample (eg, throat swab, nasopharyngeal swab, nasal aspirate, sputum) is obtained to perform the rapid test.

Code 87804 is reported twice because two separate, distinct analyses are performed, providing two separate test results, one for influenza virus A and one for influenza virus B, even if it was one test kit. Certain payers may require the use of modifier 59 when the same CPT code is used; alternatively, the payer may require use of the units box on the claim form.
Click to expand...

You are correct! But don't forget the modifiers.
Okay, I went to the source to get a definative answer about how to code the rapid flu test A/B. This is how it is done;
(87804 is with visual confirmation, and is the correct code for the quick A/B flu test per Binax)
87804QW & 8780459QW.
The QW on the first one is, of course for clia waved and the 59 on the second one is to show it was done more than once AND the second one still needs the QW to show clia waved. ja
 
BINAX says.....

Okay, I went to the source to get a definative answer about how to code the rapid flu test A/B. This is how it is done;
(87804 is with visual confirmation, and is the correct code for the quick A/B flu test per Binax)
87804QW & 8780459QW.
The QW on the first one is, of course for clia waved and the 59 on the second one is to show it was done more than once and the second one still needs the QW to show clia waved. ja
 
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