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Testing for Influenza

By:  Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Published:  July 22nd, 2016

There are several types of testing that distinguishes between influenza virus types A and B and several changes in codes in 2016.

For direct observation to detect an infectious agent by immunoassay use:

87804- Infectious agent antigen detection by immunoassay with direct optical observation; Influenza.

If the specimen is tested for both Type A and B, report 87804 twice, submitted, modifier 59, Distinct Procedural Service to indicate two separate services 87804 and 87804-59, even if only one test kit was used. Don't forget the QW Modifier.

Use 86710 for the actual test for an antibody response to influenza infection, to identify the antigen using an antibody labeled with flurophores use the following codes:

87275 - Infectious agent antigen detection by immunofluorescent technique; influenza B virus and

87276 -Infectious agent antigen detection by immunofluorescent technique; influenza A virus

To identify influenza antigen in a multistep platform using enzyme-linked antibodies use code

87400 - Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Influenza, A or B, each.

(An enzyme immunoassay test is performed to detect an infectious agent in a patient. The test examines the chemical bond between an antibody or antigen and an enzyme to identify the infectious agent. The test looks for the A or B variety of the influenza virus.)

Ref CPT Assistant Archives - rapid influenza Virus A and B Testing (code 87804) (May 2009)

Aetna.Com 

Consider the following ICD-10 codes may be covered if selection criteria are met.

B34.9                       Viral infection, unspecified

J10.00 - J11.89          Influenza due to other influenza virus

M79.1                      Myalgia

R05                         Cough

R50.9                       Fever, unspecified

R06.02                     Shortness of breath

R51                         Headache

R53.81                     Other malaise

 


References:

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