Pathology/Lab Coding Alert

Question: If we perform a Cryptosporidium/Giardia stool DFA, how should we report the service given the 2004 CPT code changes ? We use a commercial kit that has combined monoclonal antibodies to detect either parasite in one test, which yields a positive or negative result.

Florida Subscriber

Answer: You should report infectious agent antigen detection tests based on the method you use and the organism(s) you seek to identify. CPT has a group of codes (87260-87300) for the test method you describe - direct fluorescent antibody (DFA) or "immunofluorescent technique" performed on a primary source specimen such as a stool sample. Within this group, you should select the code that lists the specific organism you're testing for.
 
Prior to CPT 2004, the definition for code 87272 was Infectious agent antigen detection by immunofluorescent technique; Cryptosporidium/Giardia. This year, CPT changed 87272 and added 87269 to create a separate code for each organism: 87272 (Infectious agent antigen detection by immunofluorescent technique; Cryptosporidium) and new code 87269 (Infectious agent antigen detection by immunofluorescent technique; Giardia).
 
Neither of these codes describes your test, because you stated that it yields a single positive or negative result if either organism is present, while 87269 and 87272 identify a single organism. You have to report a code from the same code group, however, because the method is DFA (immunofluorescent technique). Since you perform one test using combined monoclonal antibodies to detect either organism, you should report the "multiple-organism" code from this group: 87300 (Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum).
 
- Reader Questions were prepared with the assistance of Laurie Castillo, MA, CPC, CPC-H, CCS-P, president of Professional Coding and Compliance Consulting in Manassas, Va.