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Thread: Rapid RSV Procedure Code

  1. #1
    Join Date
    Apr 2007
    Location
    Palm Beach
    Posts
    8

    Default Rapid RSV Procedure Code

    I hope someone can help me with this. I work for a pediatric practice and am having trouble getting BC to pay for procedure code 87807 which we are using for the Rapid RSV (respiratory syncytial virus) test because they consider it a laboratory only test.

    They are telling me that they will pay for other tests including procedure 87420 Infectious agent antigen detection by enzyme immunoassay technique, qualitative and quantitative, multiple-step method; adenovirus enteric types 40/41 respiratory synctial virus.

    Can I use this procedure instead? If not is there a better code?

    Thanks in advance for any help.
    Tracy S, CPC, CASCC

  2. #2
    Join Date
    Apr 2007
    Location
    Greeley, Colorado
    Posts
    2,046

    Default

    I think 87807 is the correct code. I'm no expert in Lab coding, but doesn't "direct optical observation" mean it is a rapid test? What codes do you use for rapid strep and rapid flu? (87880 and 87804)? If they cover those why not 87807? Same category just a different infectious agent...

    Who DOESN'T have problems with Blue Cross?
    Lisa Bledsoe, CPC, CPMA

  3. #3
    Join Date
    Apr 2007
    Location
    Palm Beach
    Posts
    8

    Default

    Lisa,

    All our other major insurance carriers are paying for the 87807 and yes we do use 87880 & 87804 for strep & flu.

    You're right it is always something with BC.

    Thank you for the info.
    Tracy S, CPC, CASCC

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