# Swine Flu Coding



## ddrew3333 (Apr 29, 2009)

Two questions.  
1) What ICD9 code should be used for swine flu?  487.0, 487.1, 487.8 or 488?
2) What CPT code should be used for the lab test for swine flu?  87804 or 87400?  CDC Recommended test:  Real-time RT-PCR for influenza A, B, H1, H3 at a State Health Department Laboratory is recommended. Currently, swine-origin influenza A (H1N1) virus will test positive for influenza A and negative for H1 and H3 by real-time RT-PCR.  If reactivity of real-time RT-PCR for influenza A is strong  (e.g.  Ct <30) it is more suggestive of a novel influenza A virus.  Confirmation as swine-origin influenza A (H1N1) virus is performed at CDC currently, but may be available in state public health laboratories soon.


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## Herbie Lorona (Apr 30, 2009)

I would say to use icd-9 488. "The influenza virus has three different types: A, B, and C. Types B and C are specific to humans. Type A affects mainly birds and is called avian influenza. There are, however, three subtypes of A known to circulate in humans. The highly pathogenic strain spreads quickly among birds and can be 100% deadly in 48 hours. It was reported causing disease in humans in Asia in 1997 and it is estimated that migratory birds could spread Asian bird flu to North America in the next year. Since influenza viruses are constantly changing, they may have adapted to infect humans and there is little immunity against the new virus.
Most cases of bird flu in humans come from contact with infected domestic poultry or surfaces contaminated with infected bird secretions or excretions. Contacting the virus from another person is extremely rare. Symptoms depend upon the particular virus and include normal flu-like symptoms to pneumonia and other severe respiratory diseases."

The CPT I am not sure but would lean more towards the 87400


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## 20Hiker16 (May 3, 2009)

I would not recommend 488 as it specifically references "Avian" Flu while the H1N1 is a combination of Human, Bird and Swine respiratory illnesses.....I would remain neutral and until a specific ICD-9-CM is assigned and use 487.1.

As far as the CPT, ?, it appears the new virus is a combination of A & B viruses: View the below site for additional information.

http://www.ama-assn.org/amednews/

CPT 87400 is a test, by "Infectious agent antigen detection by enzyme mmunoassay technique, qualitative or semiquantitative, multiple-step method;" for Influenza, A or B, Each; then CPT has the 87275 and 87286 "antigen detection by immunofluorescent technique".  (??) 
I suppose that it would depend on what the physician is *ordering* as routine or special testing which will determine how the lab processes the specimen.

But review how the CDC guide is recommending how to collect specimens for additional knowledge:

http://www.cdc.gov/h1n1flu/specimencollection.htm

I hope this will be helpful and good luck.


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