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Otolaryngology Coding Alert

Reader Question:

You Can Recoup for Nasal Swabs

Question: My allergist performed a nasal swab for respiratory syncytial virus (RSV). Should I report 87207 or 87280 for the procedure? New Jersey Subscriber Answer: Codes 87207 (Smear, primary source with interpretation; special stain for inclusion bodies or parasites [e.g., malaria, coccidia, microsporidia, trypanosomes, herpes viruses]) and 87280 (Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus) are for the laboratory’s analysis of the nasal pharyngeal swab test specimen. The Clinical Laboratory Improvement Act doesn’t include either microbiology code in the list of in-office waived tests, so you shouldn’t bill for the test unless staff perform the analysis in your office laboratory. No procedure code exists for taking a nasal-swab specimen. The work involved in taking the swab is part of the E/M service. You may recoup the cost of obtaining, handling and conveying the specimen to an outside laboratory with 99000 (Handling and/or conveyance of specimen for transfer [...]