Numerous organisms inhabit our bodies and are generally harmless under normal circumstances; however, under unfavorable circumstances, these organisms can cause damage to our bodies. Infectious diseases include urinary tract infections (UTIs), tuberculosis, measles, influenza, hepatitis C, hepatitis B, malaria, and dengue. Some examples of infectious diseases are the common cold and HIV/AIDS.
A group of medical codes known as CPT codes are used to designate medical, surgical, and diagnostic procedures for infectious illnesses. To standardize medical practices and services, they were created and are upheld by the American Medical Association (AMA). With these codes, healthcare workers can correctly report and charge for their services, ensuring they get paid for their hard work. This blog post will cover infectious disease CPT codes and how they simplify billing and reimbursement.
CPT Codes for Infectious Diseases
Bacteria, viruses, fungi, and parasites are all examples of microorganisms that can infect a human and lead to an infectious disease. It is common practice to utilize CPT codes when describing the diagnosis and treatment of infectious diseases. The following represent some of the most typical CPT codes for infectious diseases medical billing:
Codes H&P
99201-99205: To evaluate and manage a new patient, visit an office or other outpatient.
99211-99215: visit a doctor’s office or other outpatient location for the assessment and treatment of a current patient
99238-99239: administration of hospital discharge day
99251-99255: For a new or existing patient, an inpatient consultation
Codes for Laboratory Usage
87070: All sources except urine, blood, and stool can be used for bacterial culture. Isolations are then purportedly identified.
87430: Detecting infectious agents with DNA or RNA; Chlamydia trachomatis, amplified probe technique.
87804: Immunoassay-based direct optical observation for the identification of infectious agent antigens; influenza
Coding in Radiology
71045: a single image of the chest radiograph
71250: Thoracic computed tomography without contrast medium.
72170: Radiologic examination of the neck and back, at least four views
Borrelia burgdorferi antibody (Lyme disease)
86701: Lyme disease is caused by a bacterium called Borrelia burgdorferi, and this code is assigned to the laboratory test that looks for those antibodies.
Nucleic acid (DNA or RNA) is used to identify infectious agents. Respiratory viruses, such as adenoviruses, coronaviruses, influenza, metapneumoviruses, parainfluenza, respiratory syncytial, and rhinoviruses, include reverse multiplex transcription and multiplex amplified probe techniques when used.
87631: This code is reported when a lab applies a nucleic acid (DNA or RNA) detection technique, such as reverse multiplex transcription or an amplified probe approach for 20 or more targets, to detect the presence of numerous lung infections.
Detection of infectious agents by sequencing their nucleic acids (DNA or RNA); amplified probe approach for Chlamydia trachomatis
87801: This code describes a laboratory test that uses an amplified probe and a nucleic acid (DNA or RNA) detection method to find the presence of Chlamydia trachomatis.
Detection of infectious agents using an immunoassay and direct optical inspection; group A streptococcus
87880: This code is required when reporting the detection of Streptococcus group, A by using an immunoassay with direct optical observation.
Detection of infectious agents using nucleic acids (DNA or RNA); if used, only types 16 and 18 of the human papillomavirus (HPV) are detected, as well as type 45.
87498: This code is used to report the results of a lab test that looked for human papillomavirus (HPV) types 16 and 18, as well as type 45 if it was done, by looking for nucleic acid (DNA or RNA).
Bacterial culture, external source, with isolation and presumed isolate identification (excluding urine, blood, and feces).
87110: This code is used to report the culture of bacteria from a source other than urine, blood, or stool, as well as the isolation and presumed identification of the isolates.
Detection of infectious agents using nucleic acids (DNA or RNA); each organism has multiplex capability when the direct probe technique is used, allowing for detecting the first organism.
87502: This code reports direct probe detection of infectious pathogens. The test can find more than one kind of organism and can-do multiplexing.
Conclusion
The spread of infectious illnesses presents a significant problem for medical facilities worldwide. Some diseases have the potential to be fatal or create serious health issues. Hence, for better patient outcomes, precise diagnosis and treatment are crucial. Yet, the billing and reimbursement procedure can be challenging, and using the proper codes is essential to guaranteeing correct payments.