by Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
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)
Consider the following ICD-10 codes may be covered if selection criteria are met.
B34.9 Viral infection, unspecified
R50.9 Fever, unspecified
R06.02 Shortness of breath
R53.81 Other malaise