Billing and Coding: Influenza Diagnostic Tests

Influenza molecular testing (RT-PCR) is recommended for hospitalized patients with suspected influenza and for symptomatic patients with potential zoonotic exposure or discordant rapid antigen test results. Rapid antigen tests may be used if they meet high sensitivity/specificity standards, but results often warrant RT-PCR confirmation in specific epidemiologic contexts; viral culture is slower (3–10 days) and may miss antiviral treatment windows. Modifiers -59 and -QW must be reported for confirmatory PCR and CLIA‑waived tests respectively, and specimen collection should occur within 3–4 days of symptom onset following manufacturer instructions and local public health guidance.

"Hospitalized patients with suspected influenza should receive influenza testing using molecular methods (e."

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