Detection by Nucleic Acid (DNA or RNA) - Amplified Probe Technique

February 13th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Categories:   CPT® Coding   Modifiers   Laboratory|Pathology  
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This question was asked on the following lab codes used for testing during pregnancy. "Can the codes below be billed together?  87491- 59, 87591-59. 87081, 87150."

YES- CPT code 87081 is used when a specific pathogen is suspected and is appropriate.

YES- (X2) 87150 is used for culture, typing, and identification by nucleic acid (DNA or RNA) probe, amplified probe technique.  However, this code is used per culture or isolate, each organism probed and includes both codes below 87491 and 87591. Therefore, you would report if appropriate 87150 X2 UOS.  According to the MUE edits assigned it would be appropriate to report up to 12 cultures, typing, and identification.

NO - 87491 (Included in 87150) used when looking for detection by nucleic acid (DNA or RNA), using an amplified probe technique, for Chlamydia trachomatis. 

NO - 87591 (Included in 87150) also used for detection by nucleic acid (DNA or RNA), using an amplified probe technique, for Neisseria gonorrhoeae.

Modifier 59 would not be applicable on either of these codes as 87491 and 87591 are bundled into 87150 unless there is specific documentation with an educated decision to use modifier 59.

For information on Nucleic Acid Probe review the NCCI Edits Manual under Pathology/Lab services.

 87486

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