Wiki rapid flu test

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Rapid flu test

For direct optical observation (rapid flu test), the appropriate code to report is code 87804 Infectious agent antigen detection by immunoassay with direct optical observation; Influenza. To perform the rapid test, a respiratory sample (e.g., throat swab, nasopharyngeal swab, nasal aspirate, sputum) is obtained. Report code 87804 twice (even if one test kit was used) because two separate, distinct analyses are performed with separate test results: one for influenza virus A and one for influenza virus B.

Some payers may require you to use modifier 59 Distinct procedural service when the same CPT® code is used or the payer may require you to use the units box on the claim form. For Clinical Laboratory Improvement Amendments of 1998 (CLIA) waived tests, which include the CLIA number for each waived test on a claim, append modifier QW CLIA waived test to each of the following CPT® codes for them to be recognized as waived tests. For more information on CLIA waved tests,
see https://www.aapc.com/blog/27077-new-waived-tests-for-2014/

For immunofluorescent technique, use these codes:

87275 Infectious agent antigen detection by immunofluorescent technique; influenza B virus
• 87276 Infectious agent antigen detection by immunofluorescent technique; influenza A virus


For immunoassay technique, use the following code twice:

87400 Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Influenza, A or B, each

ayen

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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
 

RebeccaWoodward*

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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.
 

JacquelynA

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Definative answer from binax

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
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:

JacquelynA

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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.
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
 

JacquelynA

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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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