Billing and Coding: CPT Code 87641 (Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, methicillin resistant, amplified probe technique)

Medicare Part B considers CPT 87641 (MRSA detection by amplified probe) to be a screening test and will not pay for it when used for screening purposes per SSA §1862(a)(1)(A); such claims will be denied. Providers must include a valid ICD-10-CM diagnosis (or the test result/symptoms for diagnostic use), report referring/ordering physician name and NPI when required, use modifier -GY as applicable, and be aware that NCCI/OPPS edits may affect billing.

"CPT code 87641 is non-covered when used for screening purposes and claims billed for screening MRSA will be denied under Medicare Part B."

Sign up to see full coverage criteria, indications, and limitations.