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87426

COVID-19 Antigen Test

Code Description

CPT code 87426 is used to report an immunoassay test that detects the presence of the SARS-CoV-2 (COVID-19) antigen in a patient specimen. The test provides qualitative or semiquantitative results and is commonly used as a rapid diagnostic test for active COVID-19 infection.

When to Use 87426

Common examples include:

  • Symptomatic COVID-19 testing

  • Rapid COVID-19 screening

  • Urgent care testing

  • Emergency department testing

  • Occupational health screening

  • Pre-procedure COVID-19 testing

  • Point-of-care antigen testing

Documentation Requirements

Documentation should include:

  • Medical necessity for testing

  • Ordering provider

  • Specimen source

  • Test result

  • Date of specimen collection

  • Complete laboratory report

Examples
Example 1

A patient presents to an urgent care clinic with fever, cough, and sore throat. A rapid COVID-19 antigen test is performed using an immunoassay method to evaluate for active SARS-CoV-2 infection. CPT code 87426 is reported.

Example 2

A healthcare worker develops respiratory symptoms after a workplace exposure. A point-of-care COVID-19 antigen test is performed in the office to determine whether the individual has an active infection, making CPT code 87426 the appropriate code.

Common Billing Mistakes

Common billing mistakes include:

  • Reporting 87426 for molecular (PCR) testing

  • Billing the wrong COVID-19 laboratory code

  • Insufficient documentation supporting medical necessity

  • Incorrect specimen documentation

  • Duplicate laboratory billing

Related CPT Codes
87635

COVID-19 PCR Test

85025

Complete Blood Count (CBC) With Automated Differential

85610

Prothrombin Time (PT)

FAQ

What does CPT code 87426 cover?

CPT code 87426 reports an immunoassay antigen test used to detect an active SARS-CoV-2 (COVID-19) infection.

Is CPT 87426 a rapid COVID-19 test?

Yes. CPT 87426 is commonly used to report rapid antigen testing performed using immunoassay technology.

What is the difference between CPT 87426 and 87635?

CPT 87426 detects COVID-19 antigens using an immunoassay, while CPT 87635 detects SARS-CoV-2 genetic material using nucleic acid amplification (PCR) technology.

When is CPT 87426 commonly performed?

It is commonly performed in physician offices, urgent care centers, emergency departments, and other healthcare settings for rapid evaluation of active COVID-19 infection.

Procedure Type

Infectious Agent Antigen Detection

Test Type

Detection Method

COVID-19 Antigen Test

Immunoassay