Pediatric Coding Alert

Reviewed on April 23, 2015 Latest on CPT Code 87880 for Rapid Strep Test from Codify's Pediatric Coder Rapid strep test: A throat culture test to check whether the patient has Group A Streptococcus. Streptococcus: A bacterium commonly found on the skin or in the throat that can cause a range of infections, from a mildly sore throat or skin infection to potentially life-threatening disease Tips: Code 87880 represents a test for Group A Streptococcus, often known as a "rapid" strep test. These tests can produce results within minutes to hours, depending on the actual test administered. A rapid strep test can only detect the presence of... Quick strep tests those done in the office by most pediatricians are often miscoded. Also, there have been some changes in recent years in strep test codes, so some practices may be using outdated codes. In fact, there are so many different codes for strep tests in CPT that its easy to get confused about which one to use. Jaleh Shaheedy office manager for M. Shaheedy MD of Van Nuys CA writes to say that she is using five different codes. These codes hardly pay for the price of the supply that we buy to do the test Shaheedy notes. The correct code to use for a quick strep test is 87880. This is for infectious agent detection by immunoassay with direct optical observation; Streptococcus group A. The key words here are direct optical observation notes Mark Synovec MD CPT-4 advisor for the American Society of Clinical Pathologists. Using the code definitions if you are using a kit that requires direct opticali.e. visualobservation to determine if the Strep A antigen is positive then code 87880 is appropriate says Synovec. If it is still an immunoassay but you dont visualize the reaction directlysuch as with instrumentationthen 87430 is most appropriate. However most pediatricians do the rapid test and should be using 87880. Further clarification of strep test coding comes from the American Medical Association which has received a number of queries regarding these codes. In the December issue of CPT Assistant the AMA comments that 87880 should be used for all immunologically based commercial Streptococcus Group A testing kits whose interpretation rely on a visual reaction observed by the naked eye. 87449 Is Incorrect Coding One incorrect code that has commonly been used for the rapid strep test is 87449 (Infectious agent antigen detection by enzyme immunoassay technique qualitative or semiquantitative; multiple step method, not otherwise specified, each organism). Another commonly used incorrect code for strep tests is 86403 (Particle agglutination; screen, each antibody). Code 86558 is not a valid code Educating Payers  Check the list of tests granted waived status under the Clinical Laboratory [...]