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Candida species billling

Apurva Posted Fri 12th of June, 2020 05:08:54 AM
Need clarification as to whether CPT 87801 can be billed for Candida glabrata:Candida albicans C. tropicalis C.dubliniesis C. parapsilosis: instead of 87481
SuperCoder Answered Mon 15th of June, 2020 13:36:17 PM

Hi Apurva,

It is appropriate to use CPT code 87481 (Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique) for Candida species. This code is specific for candida species.

However, CPT 87801 is used when multiple species are involved.

NOTE:

Although not limited to testing for a specific condition, clinicians may order this test to diagnose infection with Candida species, which is a commonly occurring yeast organism that may be associated with pathological conditions such as vaginal infections and throat infection, called thrush.

Feel free to ask for any further query.

Apurva Posted Mon 15th of June, 2020 23:51:10 PM
Thanks for the reply !!! The concern here is for multiple candida species can we bill 87801*1 or 87481*1. 87801 (Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique ) and 87481 (Infectious agent detection by nucleic acid (DNA or RNA); Candida species, amplified probe technique )
SuperCoder Answered Wed 17th of June, 2020 01:13:25 AM

CPT 87801, Use this code to represent a single test that involves amplified probes (multiple probes) for multiple organisms. MUE for this code is 3. i.e; we can bill this code thrice in a day.

CPT 87481, use this code to represent a single test that involves amplified probe for candidas species only. MUE for this code is 5. i.e; we can bill this code five time in a day depending upon the number of times the test is performed and the number of test results.

Hope it helps. 

 

 

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