Pathology/Lab Coding Alert

Question: What ICD-9 and CPT codes should we report for a negative strep test?

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Answer: Because the lab doesnt assign a diagnosis code based on lab test results, you should report the same ICD-9 code for a positive or negative strep test. List the ICD-9 code that the ordering physician indicated as the reason for the test, such as 462 (Acute pharyngitis).

You should choose the CPT code for the strep test based on the lab method. For instance, for a rapid step test, you might report 87880 (Infectious agent detection by immunoassay with direct optical observation; Streptococcus, group A).

Dont miss: If your lab operates with a certificate of waiver under the Clinical Laboratory Improvement Amendments (CLIA), you should append modifier QW (CLIA waived test).

The following are some other codes you might use to describe a strep test, depending on the lab method:

" 87070 -- Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates

" 87430 -- Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; Streptococcus, group A

" 87650 -- Infectious agent detection by nucleic acid (DA or RNA); Streptococcus, group A, direct probe technique

" 87651 -- & Streptococcus, group A, amplified probe technique.