Home > All CPT Codes > Pathology > 87365

87365

COVID-19 Antigen Test

Code Description

CPT code 87635 is used to report a molecular laboratory test that detects SARS-CoV-2 (COVID-19) using nucleic acid amplification technology, such as polymerase chain reaction (PCR). The test identifies viral RNA and is widely used to diagnose active COVID-19 infection due to its high sensitivity and specificity.

When to Use 87635

Common examples include:

  • Diagnostic COVID-19 PCR testing

  • Symptomatic patient evaluation

  • Hospital admission testing

  • Preoperative COVID-19 screening

  • Emergency department testing

  • Public health testing

  • Confirmatory COVID-19 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 with fever, cough, and shortness of breath undergoes a nasopharyngeal swab for PCR testing to confirm suspected COVID-19 infection. CPT code 87635 is reported.

Example 2

A patient scheduled for elective surgery undergoes preoperative SARS-CoV-2 PCR testing according to hospital protocol. The laboratory performs a nucleic acid amplification test, making CPT code 87635 the appropriate code.

Common Billing Mistakes

Common billing mistakes include:

  • Reporting 87635 for antigen testing

  • Selecting the wrong COVID-19 laboratory code

  • Duplicate laboratory billing

  • Inadequate documentation

  • Incorrect diagnosis coding

Related CPT Codes
87426

COVID-19 Antigen Test

85025

Complete Blood Count (CBC) With Automated Differential

85610

Prothrombin Time (PT)

FAQ

What does CPT code 87635 cover?

CPT code 87635 reports a molecular nucleic acid amplification (PCR) test used to detect SARS-CoV-2 (COVID-19).

Is CPT 87635 a PCR test?

Yes. CPT 87635 reports nucleic acid amplification testing, including PCR methods, for detecting SARS-CoV-2.

What is the difference between CPT 87635 and 87426?

CPT 87635 detects viral genetic material using PCR technology, while CPT 87426 detects viral antigens using an immunoassay.

When is CPT 87635 commonly performed?

It is commonly performed for diagnosing active COVID-19 infection, hospital admissions, preoperative screening, public health testing, and confirmatory testing.

Procedure Type

Molecular Pathology

Test Type

Detection Method

COVID-19 PCR Test

Nucleic Acid Amplification (PCR)