The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. CPT codes . No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be Please help me in coding this. Rapid qualitative test that detects Influenza type A and type B antige . Billing & Coding. Local Coverage Articles are a type of educational document published by the Medicare Administrative Contractors (MACs). Applicable FARS/HHSARS apply. Positive and negative included. PPA* (versus an FDA-cleared influenza A and B molecular assay) A: 81.5%, B: 80.9%. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. Collect respiratory tract specimens as early in the illness as possible (within 3-4 days of illness onset). The Sofia Influenza A+B Fluorescent Immunoassay (FIA) uses advanced immunofluorescence-based lateral-flow technology to detect influenza A and influenza B viral nucleoprotein antigens. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt. Qty Check Availability. Draft articles are articles written in support of a Proposed LCD. The AMA does not directly or indirectly practice medicine or dispense medical services. recommending their use. presented in the material do not necessarily represent the views of the AHA. Influenza viruses. The license granted herein is expressly conditioned upon your acceptance of all terms and conditions contained in this agreement. These tests provide results in 10-15 minutes and differentiate between influenza A and B. that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes. This email will be sent from you to the CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. . Harmon MW, Kendal AP. If a CLIA-waived test is performed, the -QW modifier should be reported for the waived test. The Medicare program provides limited benefits for outpatient prescription drugs. Manipulation & E/M. will not infringe on privately owned rights. Tests will be run in the order of receipt only, tests remaining at the end of each shift will be reordered under NCVQLT for transport to UW Virology. Please do not use this feature to contact CMS. endstream endobj startxref CPT codes, descriptions and other data only are copyright 2022 American Medical Association. Articles often contain coding or other guidelines that are related to a Local Coverage Determination (LCD). The American Medical Association today released for immediate use Current Procedural Terminology codes for reporting on medical claims two laboratory tests (87636 and 87637) that simultaneously detect the COVID-19 virus, influenza A/B and respiratory syncytial virus. By clicking below on the button labeled "I accept", you hereby acknowledge that you have read, understood and agreed to all terms and conditions set forth in this agreement. A patient has had recent close exposure (this does NOT include eating cooked meat) to pigs or birds (including poultry) or other animals, and there is concern for infection with a novel influenza A virus. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Use modifier 59 when separate results are reported for different species or strains, same laboratory test on the same day to obtain subsequent test results. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). presented in the material do not necessarily represent the views of the AHA. Telehealth provides a way for physicians to provide care while keeping patients safe in their homes. An asterisk (*) indicates a The new additions and revisions to the CPT code set have been approved for immediate use. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work Reference: Centers for Disease Control and Prevention. This instructional video reviews the items included in the McKesson Consult Flu Test Kit and provides an overview of step-by-step instructions for using this test kit. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). End Users do not act for or on behalf of the CMS. This study evaluated the BD Veritor System Flu A+B (Veritor; BD Diagnostics, Sparks, MD, USA), Quidel Sofia Influenza A+B FIA (Sofia; Quidel Corp., San Diego, CA, USA), and Alere BinaxNOW Influenza A&B (Binax; Alere Scarborough, Inc., Scarborough, ME, USA) compared to reverse transcription-polymerase . End User License Agreement: Shell vials or equivalent multiwell plate cell culture; identification (additional CPT codes/charges will apply) if culture results warrant. The AMA assumes no liability for data contained or not contained herein. Response to Comment (RTC) articles list issues raised by external stakeholders during the Proposed LCD comment period. Some articles contain a large number of codes. Some tests are waived from requirements under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and cleared for point-of-care use. Source: Regenstrief LOINC Part Description . Contractors may specify Bill Types to help providers identify those Bill Types typically Effective March 5, 2020. an effective method to share Articles that Medicare contractors develop. CLIA waived; Current Dental Terminology © 2022 American Dental Association. Copyright © 2022, the American Hospital Association, Chicago, Illinois. RT-PCR or other amplification methods to detect viral nucleic acids, Results available in < 24 hours (often in less than 2-4 hours), Detects from 1-2 to up to 20 respiratory pathogens from 1 specimen. 87636: Infectious agent detection by nucleic acid (DNA or RNA); severe . Cleared for use with multiple viral transport media (VTM) types. Before sharing sensitive information, make sure you're on a federal government site. Absence of a Bill Type does not guarantee that the Please do not use this feature to contact CMS. The Panbio COVID-19/Flu A&B Rapid Panel test kit was used in the assays. This article is being revised in order to adhere to CMS requirements per chapter 13, section 13.5.1 of the Program Integrity Manual. Some articles contain a large number of codes. Set yourself up for success with tips and tools on choosing a residency program. Complete absence of all Revenue Codes indicates copied without the express written consent of the AHA. A positive result (on testing of an upper respiratory tract specimen) in a person who recently received intranasal administration of live attenuated influenza virus vaccine (LAIV) may indicate detection of vaccine virus. The American Medical Association is the physicians powerful ally in patient care. The scope of this license is determined by the AMA, the copyright holder. 2009;13(1):15-18. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology, so it can fulfill its vital role as the trusted language of medicine today and the code to its future. Some minor issues are listed as follows. If you do not agree with all terms and conditions set forth herein, click below on the button labeled "I do not accept" and exit from this computer screen. Therefore, if a drug is self-administered by more than 50 percent of Medicare beneficiaries, the drug is excluded from coverage" and the MAC will make no payment for the drug. Instructions for enabling "JavaScript" can be found here. resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; used to report this service. As long as your test in the office checks for both the A and B strains, you can bill for two tests (CPT 87804 and add modifier 59 to the second test as the previous reply mentions). No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be End User Point and Click Amendment: hbbd```b``z"gIi MD>*{`S`0 AMA has new CPT codes for dual flu-COVID-19 tests. An official website of the United States government. Next video. The CMS.gov Web site currently does not fully support browsers with The results were evaluated based on PCR ct values. 5 things you should know. required field. Turnaround time is defined as the usual number of days from the date of pickup of a specimen for In addition, we will perform experimental evolution in Escherichia coli and influenza to test hypotheses related to the change of fitness effects across environments, and to adaptation by means of highly epistatic mutations. When community influenza activity is high and the rapid diagnostic test result is negative. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. If you are looking for a specific code, use your browser's Find function (Ctrl-F) to quickly locate the code in the article. "JavaScript" disabled. Find an overview of AMA efforts and initiatives to help improv GME. Indicate a specific test number on the test request form. The AMA is a third party beneficiary to this Agreement. Most RIDTs are immunoassays that utilize antibodies against the nucleoproteins of influenza A and B viruses to detect viral antigens. #7. JavaScript is disabled. DISCLOSED HEREIN. of the Medicare program. Molnlycke Exufiber absorption comparison. Rapid influenza diagnostic tests (RIDTs) are immunoassays that can identify the presence of influenza A and B viral nucleoprotein antigens in respiratory specimens, and display the result in a qualitative way (positive vs. negative) (1). The page could not be loaded. of every MCD page. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available. ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, Information for Clinicians on Rapid Diagnostic Testing for Influenza, VIRUS ISOLATION; TISSUE CULTURE INOCULATION, OBSERVATION, AND PRESUMPTIVE IDENTIFICATION BY CYTOPATHIC EFFECT, VIRUS ISOLATION; TISSUE CULTURE, ADDITIONAL STUDIES OR DEFINITIVE IDENTIFICATION (EG, HEMABSORPTION, NEUTRALIZATION, IMMUNOFLUORESCENCE STAIN), EACH ISOLATE, VIRUS ISOLATION; CENTRIFUGE ENHANCED (SHELL VIAL) TECHNIQUE, INCLUDES IDENTIFICATION WITH IMMUNOFLUORESCENCE STAIN, EACH VIRUS, INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA B VIRUS, INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA A VIRUS, INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE (EG, ENZYME IMMUNOASSAY [EIA], ENZYME-LINKED IMMUNOSORBENT ASSAY [ELISA], FLUORESCENCE IMMUNOASSAY [FIA], IMMUNOCHEMILUMINOMETRIC ASSAY [IMCA]), QUALITATIVE OR SEMIQUANTITATIVE; INFLUENZA, A OR B, EACH, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, INCLUDES REVERSE TRANSCRIPTION, WHEN PERFORMED, AND AMPLIFIED PROBE TECHNIQUE, EACH TYPE OR SUBTYPE, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, FOR MULTIPLE TYPES OR SUB-TYPES, INCLUDES MULTIPLEX REVERSE TRANSCRIPTION, WHEN PERFORMED, AND MULTIPLEX AMPLIFIED PROBE TECHNIQUE, FIRST 2 TYPES OR SUB-TYPES, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, FOR MULTIPLE TYPES OR SUB-TYPES, INCLUDES MULTIPLEX REVERSE TRANSCRIPTION, WHEN PERFORMED, AND MULTIPLEX AMPLIFIED PROBE TECHNIQUE, EACH ADDITIONAL INFLUENZA VIRUS TYPE OR SUB-TYPE BEYOND 2 (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL (IE, VISUAL) OBSERVATION; INFLUENZA. Waner JL, Todd, SI, Shalaby H, et al. Influenza testing (using molecular methods) is recommended for hospitalized patients with suspected influenza. You, your employees and agents are authorized to use CPT only as agreed upon with the AMA internally within your organization within the United States for the sole use by yourself, employees and agents. Effective April 3 . All rights reserved. All rights reserved. Sign up to get the latest information about your choice of CMS topics in your inbox. The views and/or positions You can collapse such groups by clicking on the group header to make navigation easier. 87637 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique. Negative . Includes: Influenza A & B. Accessed 4/27/21. recipient email address(es) you enter. 0 CPT Code: 87804QW and 87804 (see table) Sensitivity: 100% (Flu A); 93% (Flu B) Specificity: 96% (Flu A); 97% (Flu B) One-step, rapid immunochromatographic assay; Qualitative detection of influenza A and B nucleoprotein antigens ; A and B are separate results/separate tests. Please visit the. apply equally to all claims. U0005 will be added at an additional charge consistent with applicable payer requirements), 87804 (x2), 8467. . A patient has had recent close exposure (this does NOT include eating cooked meat) to pigs or birds (including poultry) or other animals, and there is concern for infection with a novel influenza A virus. Organizations who contract with CMS acknowledge that they may have a commercial CDT license with the ADA, and that use of CDT codes as permitted herein for the administration of CMS programs does not extend to any other programs or services the organization may administer and royalties dues for the use of the CDT codes are governed by their commercial license. Under Article Text subheading Reference the access date was . The views and/or positions Administration of influenza virus vaccine (allowable same as CPT 90471) 90653: Influenza virus vaccine, inactivated, subunit, adjuvanted, for intramuscular use: 90662: Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use: 90672 LOINC Code 95942-9 Influenza virus A and B and SARS-CoV+SARS-CoV-2 (COVID-19) Ag panel - Upper respiratory specimen by Rapid immunoassay. Influenza testing (using molecular methods) is recommended for hospitalized patients with suspected influenza. The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association have announced the release of several new codes to report testing for Coronavirus (COVID-19). - 3 in 1 Format; Three tests results with one simple procedure. Billing and Coding articles provide guidance for the related Local Coverage Determination (LCD) and assist providers in submitting correct claims for payment. Centers for Disease Control and Prevention (CDC) recommendations: Use rapid diagnostic tests with high sensitivity and specificity. Learn more with the AMA. Current Dental Terminology © 2022 American Dental Association. not endorsed by the AHA or any of its affiliates. 10/24/2019. Code 87804 (infectious agent antigen detection by immunoassay with direct optical observation; influenza) is appropriate for these tests, which are Clinical Laboratory Improvement Amendments (CLIA) waived (ie . damages arising out of the use of such information, product, or process. Your MCD session is currently set to expire in 5 minutes due to inactivity. Another option is to use the Download button at the top right of the document view pages (for certain document types). Yes, agreed. Use of CDT is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). The code joins other COVID-19 testing codes already approved by the CPT Editorial Panel, an independent body convened by the AMA that has the sole authority to expedite the review of proposed changes and additions to the CPT code set. Please note, effective Jan. 1, 2021, tests U0003 and U0004 will be reimbursed at $75 when not completed within two calendar days of the specimen being collected. For swabs in saline: OP, NP or anterior nasal swabs may be placed in 1 to 3 mL of sterile saline (0.85 to 0.9%) in a sterile screw cap container. authorized with an express license from the American Hospital Association. Applicable Federal Acquisition Regulation Clauses (FARS)/Department of Defense Federal Acquisition Regulation supplement (DFARS) Restrictions Apply to Government Use. Intended for the qualitative detection ofinfluenza type A and type B nucleoproteinantigens directly from nasal andnasopharyngeal swab specimens frompatients with signs and symptoms ofrespiratory infection. The AMA does not directly or indirectly practice medicine or dispense medical services. The suggested*** CPT codes are: Influenza A: 87804 . Reporting negatives and combined reporting in 30 minutes. An asterisk (*) indicates a Van Voris LP. Issue briefs summarize key health policy issues by providing concise and digestible content for both relevant stakeholders and those who may know little about the topic. Of these, only two showed a positive RAD test for Influenza A. The views and/or positions presented in the material do not necessarily represent the views of the AHA. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not End User License Agreement: iPhone or However, please note that once a group is collapsed, the browser Find function will not find codes in that group. No fee schedules, basic unit, relative values or related listings are included in CPT. It is typified by the Quidel's QuickVue Influenza test. However, testing is not needed for all outpatients with signs and symptoms consistent with influenza before making antiviral treatment decisions, particularly once influenza activity has been documented in the community. This revision affects the newly developed descriptor for CPT code 87426. Anterior nasal swabs (self-collected under healthcare provider (HCP) supervision or HCP-collected) are also considered . For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. Also, you can decide how often you want to get updates. that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes. What is the CMS suggested CPT code and National Limit for the Sofia Influenza A+B FIA? Self-Administered Drug (SAD) Exclusion List articles list the CPT/HCPCS codes that are excluded from coverage under this category. "JavaScript" disabled. preparation of this material, or the analysis of information provided in the material. Influenza Viruses Detected Influenza A Virus Subtypes Differentiated Other Respiratory Viruses Differentiated Approved Specimens 3 Test Time 4; High, Moderate: BioFire Diagnostics, LLC (Commercially Available) BioFire Respiratory Panel 2.1 (RP2.1) Nucleic Acid Detection: FILMARRAY 2.0 and FILMARRAY TORCH systems: Influenza A, Influenza B: A . This Agreement will terminate upon notice if you violate its terms. Per the office this is a nasal swab. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "I Accept". Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "I Accept". will not infringe on privately owned rights. Immunofluorescence (IF) - Direct (DFA) or Indirect (IFA) Fluorescent Antibody Staining (antigen detection): If a rapid antigen test is performed and then confirmed using PCR, the second test may require the -59 modifier. GOVERNMENT AND ITS EMPLOYEES ARE NOT LIABLE FOR ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION, PRODUCT, OR PROCESSES CPT code for the rapid flu test. Rapid Test Kit McKesson Consult Infectious Disease Immunoassay Influenza A + B Nasal Swab / Nasopharyngeal Wash / Nasopharyngeal Aspirate Sample 25 Tests CLIA Waived. Version 2.73 72367-6Influenza virus A+B Ag [Presence] in Nose by Rapid immunoassayActive Term Description This test is intended to encode results for tests which detect but do not differentiate Influenza type A and B viral antigens from nasal swab or nasal wash specimen in 10 minutes or less. f Zhq,3&,w+0bv ]LL Testing schedules may vary. The Cepheid Xpert Xpress SARS-CoV-2/Flu/RSV assay is a rapid, real-time RT-PCR test intended for the simultaneous qualitative detection and differentiation of SARS-CoV-2, influenza A, influenza B, and respiratory syncytial virus (RSV) viral DNA in either nasopharyngeal swab, nasal swab or nasal wash/aspirate specimens collected from individuals suspected of respiratory viral infection . 7500 Security Boulevard, Baltimore, MD 21244. AMA members get discounts on prep courses and practice questions. Instructions for enabling "JavaScript" can be found here. Test Includes. CPT/ HCPCS Code Laboratory Code Long Descriptor Target . MODIFIER -59 IS USED TO IDENTIFY PROCEDURES/SERVICES THAT ARE NOT NORMALLY REPORTED TOGETHER, BUT ARE APPROPRIATE UNDER THE CIRCUMSTANCES. When we billed Medicare for both of these CPTs they were denied . . Clinical significance: Influenza is an acute viral disease that is seasonal in incidence, occurring in the colder months. Reference: Centers for Disease Control and Prevention. You need modifer -QW for Medicare patients. Find information about the summary of panel actions, a document prepared after each meeting of the CPT editorial panel. AHA copyrighted materials including the UB‐04 codes and Collect respiratory tract specimens as early in the illness as possible (within 3-4 days of illness onset). Version 2.74 Status COVID-19/Flu A&B: - USA Manufactured and Delivered. Do not use transport devices beyond their expiration date. RIDTs usually involve inserting a swab into your nostril to get a sample. It may not display this or other websites correctly. opportunity for Oseltamivir (Tamiflu) treatment for positive patients, Results available in approximately 2-4 hours, Article - Billing and Coding: Influenza Diagnostic Tests (A59055). CPT codes, descriptions and other data only are copyright 2022 American Medical Association. Some older versions have been archived. 1. Instructions for enabling "JavaScript" can be found here. Federal government websites often end in .gov or .mil. CMS has defined "not usually self-administered" according to how the Medicare population as a whole uses the drug, not how an individual patient or physician may choose to use a particular drug. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT for resale and/or license, transferring copies of CDT to any party not bound by this agreement, creating any modified or derivative work of CDT, or making any commercial use of CDT. A Draft article will eventually be replaced by a Billing and Coding article once the Proposed LCD is released to a final LCD. Laboratory Tests for which Medicare Allows One Test Without a Practitioner Order During the PHE* Updated May 5, 2021 . Accessed 4/27/21. The illness classically presents with sudden onset . In the United States, a number of RIDTs are commercially available. The Medicare National Limit amount* is $16.36. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. HOWEVER, WHAN ANOTHER ALREADY ESTABLISHED MODIFIER IS APPROPRIATE IT SHOULD BE USED RATHER THAN MODIFIER -59. Throat or nasopharyngeal (NP) swab or wash, sputum, bronchial washings, bronchoalveolar lavage (BAL). In: Balows A, Hausler WJ, et al, eds. For Use With (Application) For the detection of Influenza type A and type B nucleoprotein antigens. Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. FDA) now requires that all Rapid influenza diagnostic tests (RIDTs) achieve 80% or higher sensitivity compared with RT-PCR. Influenza viruses. Concurrent detection promises to conserve important testing resources, allowing for ongoing surveillance of influenza while testing for the novel coronavirus.. 7500 Security Boulevard, Baltimore, MD 21244. INFLUENZA A & B - CONTROL SWAB KIT 425-080 CPT CODE: 87502-QW . We code 87804 and 87804-59 if both A and B are tested and results documented. Effective immediately, coders . The CPT Editorial Panel also revised CPT codes ranging from 87301 to 87430 by removing the undefined term multi step method from code descriptors. accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the . By clicking below on the button labeled "I accept", you hereby acknowledge that you have read, understood and agreed to all terms and conditions set forth in this agreement. an effective method to share Articles that Medicare contractors develop. While every effort has been made to provide accurate and Reproduced with permission. The page could not be loaded. The laboratory has the capacity for a maximum of 8 rapid tests (FABRCV + NCVRPD) every hour. The AMA is a third party beneficiary to this Agreement. Influenza Type A and Type B. If a CLIA-waived test is performed, the -QW modifier should be reported for the waived test. Learn more. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. Accurate and reliable detection of Flu A and Flu B in as soon as 20 minutes*. In some cases, additional time should be During the exam, the physician observes swollen and red tonsils. [COVID-19]), influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique 87811 - Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) Special Services, Procedures and Reports CPT code 99072 was created in response to the significant additional practice expenses of the Medicare program. Unless specified in the article, services reported under other recipient email address(es) you enter. The AMA is your steadfast ally from classroom to Match to residency and beyond. For a better experience, please enable JavaScript in your browser before proceeding. All rights reserved. The AMA assumes no liability for data contained or not contained herein. If a rapid antigen test is performed and then confirmed using PCR, the second test may require the -59 modifier. Shell vials or equivalent multiwell plate cell culture; identification (additional CPT codes/charges will apply) if culture results warrant. copied without the express written consent of the AHA. ICD-10-CM Codes that Support Medical Necessity, ICD-10-CM Codes that DO NOT Support Medical Necessity, Information for Clinicians on Rapid Diagnostic Testing for Influenza, VIRUS ISOLATION; TISSUE CULTURE INOCULATION, OBSERVATION, AND PRESUMPTIVE IDENTIFICATION BY CYTOPATHIC EFFECT, VIRUS ISOLATION; TISSUE CULTURE, ADDITIONAL STUDIES OR DEFINITIVE IDENTIFICATION (EG, HEMABSORPTION, NEUTRALIZATION, IMMUNOFLUORESCENCE STAIN), EACH ISOLATE, VIRUS ISOLATION; CENTRIFUGE ENHANCED (SHELL VIAL) TECHNIQUE, INCLUDES IDENTIFICATION WITH IMMUNOFLUORESCENCE STAIN, EACH VIRUS, INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA B VIRUS, INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA A VIRUS, INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY TECHNIQUE (EG, ENZYME IMMUNOASSAY [EIA], ENZYME-LINKED IMMUNOSORBENT ASSAY [ELISA], FLUORESCENCE IMMUNOASSAY [FIA], IMMUNOCHEMILUMINOMETRIC ASSAY [IMCA]), QUALITATIVE OR SEMIQUANTITATIVE; INFLUENZA, A OR B, EACH, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, INCLUDES REVERSE TRANSCRIPTION, WHEN PERFORMED, AND AMPLIFIED PROBE TECHNIQUE, EACH TYPE OR SUBTYPE, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, FOR MULTIPLE TYPES OR SUB-TYPES, INCLUDES MULTIPLEX REVERSE TRANSCRIPTION, WHEN PERFORMED, AND MULTIPLEX AMPLIFIED PROBE TECHNIQUE, FIRST 2 TYPES OR SUB-TYPES, INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); INFLUENZA VIRUS, FOR MULTIPLE TYPES OR SUB-TYPES, INCLUDES MULTIPLEX REVERSE TRANSCRIPTION, WHEN PERFORMED, AND MULTIPLEX AMPLIFIED PROBE TECHNIQUE, EACH ADDITIONAL INFLUENZA VIRUS TYPE OR SUB-TYPE BEYOND 2 (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE), INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL (IE, VISUAL) OBSERVATION; INFLUENZA.
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