Influenza Rapid Diagnostic Tests

Rapid influenza antigen tests (e.g., Directigen, Quickvue) are medically necessary and covered — including CPT 87804 when selection criteria are met — for outpatient/office or moderately complex lab use to help distinguish influenza from other viral infections when the clinical diagnosis is uncertain. These antigen-based RIDTs have variable/often suboptimal sensitivity (notably poor for 2009 H1N1), can produce false negatives or false positives depending on specimen type and community activity, do not subtype influenza A, and negative results with high clinical suspicion (or during H1N1 concerns) should be confirmed by viral culture or molecular testing.

"Tests to help distinguish influenza from other viral infections (and occasionally streptococcal pharyngitis) in patients with headache, muscle aches, fever, and/or cough when the clinical diagnosis..."

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