Laboratory Question for the Week of January 2, 2017

Laboratory Compliance Question of the Week

Question:

If a physician performs tests for cytomegalovirus antigen at an anatomic site by immunoassay (CPT code 87332) and by nucleic acid direct probe (CPT code 87495), can both of these codes be reported?

Answer:

No, only one of these codes may be reported for the testing. With one exception, Medicare policy prohibits sepa¬rate payment for testing for a single microorganism from an anatomic site by more than one method¬ology. If a culture independent diagnostic testing method is positive for a microorganism, it may be medi¬cally reasonable and necessary to additionally cul¬ture the microorganism for drug-sensitivity testing or rarely for community-surveillance identification.

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