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Official Description

Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 87290 refers to a laboratory test specifically designed for the detection of the Varicella zoster virus (VZV) antigen using an immunofluorescent technique. This test is crucial for identifying the presence of VZV in vesicular lesions or tissue samples. Varicella zoster virus is classified as a linear double-stranded, enveloped DNA virus that belongs to the herpesviridae family. It is primarily known for causing primary varicella infection, commonly referred to as chickenpox, which predominantly affects children. The clinical presentation of chickenpox includes fever and a generalized rash that evolves through distinct stages, starting from macular lesions to papular and finally to vesicular forms. In addition to causing chickenpox, VZV can also lead to a latent infection known as shingles, which is characterized by inflammation of a posterior nerve root. This condition results in the eruption of painful vesicular lesions associated with the sensory nerve ganglia. The laboratory test involves obtaining a sample through swabbing or scraping the affected vesicular lesions or inflamed tissue. The collected sample is then inoculated with antibodies specific to the Varicella zoster virus, which are conjugated to fluorescein isothiocyanate. This mixture is examined under an epifluorescence microscope. If the Varicella zoster virus is present in the sample, the antibodies will bind to the viral antigens, resulting in a bright green fluorescence, while non-infected surrounding cells will exhibit a dull red fluorescence. Although this immunofluorescent test is relatively rapid, it is important to note that it may be less sensitive compared to reverse transcription-polymerase chain reaction (RT-PCR) methods for detecting VZV.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The CPT® Code 87290 is indicated for the detection of the Varicella zoster virus antigen in specific clinical scenarios. The following conditions warrant the use of this test:

  • Vesicular Lesions The test is performed on patients presenting with vesicular lesions that may be indicative of a Varicella zoster virus infection.
  • Suspected Chickenpox It is indicated for individuals suspected of having primary varicella infection, commonly known as chickenpox, characterized by fever and a generalized rash.
  • Suspected Shingles The test may also be utilized in cases where shingles (latent zoster infection) is suspected, particularly when painful vesicular lesions are present along a sensory nerve pathway.

2. Procedure

The procedure for conducting the test under CPT® Code 87290 involves several critical steps to ensure accurate detection of the Varicella zoster virus antigen. The following procedural steps are outlined:

  • Step 1: Sample Collection A sample is obtained from the patient by swabbing or scraping the vesicular lesions or inflamed tissue. This step is crucial as it ensures that the sample contains potential viral antigens for testing.
  • Step 2: Sample Preparation The collected sample is then prepared for testing by inoculating it with Varicella zoster virus antibodies that are conjugated to fluorescein isothiocyanate. This preparation is essential for the subsequent detection of the virus.
  • Step 3: Microscopic Examination The prepared sample is examined using an epifluorescence microscope. This specialized equipment allows for the visualization of the fluorescently labeled antibodies binding to the viral antigens.
  • Step 4: Interpretation of Results If the Varicella zoster virus is present in the sample, the antibodies will attach to the viral antigens, resulting in a bright green fluorescence. In contrast, non-infected surrounding cells will stain a dull red, aiding in the differentiation between infected and non-infected cells.

3. Post-Procedure

After the completion of the test, there are no specific post-procedure care requirements mentioned for patients. However, it is essential for healthcare providers to interpret the results accurately and communicate them to the patient. If the test indicates the presence of the Varicella zoster virus, appropriate clinical management and treatment options should be discussed with the patient based on their clinical presentation and overall health status. Additionally, follow-up care may be necessary depending on the patient's condition and the results of the test.

Short Descr VARICELLA ZOSTER AG IF
Medium Descr IAADI VARICELLA ZOSTER VIRUS
Long Descr Infectious agent antigen detection by immunofluorescent technique; Varicella zoster virus
Status Code Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 9 - Not Applicable
Multiple Procedures (51) 9 - Concept does not apply.
Bilateral Surgery (50) 9 - Concept does not apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 9 - Concept does not apply.
Co-Surgeons (62) 9 - Concept does not apply.
Team Surgery (66) 9 - Concept does not apply.
Diagnostic Imaging Family 99 - Concept Does Not Apply
CLIA Waived (QW) No
APC Status Indicator Conditionally packaged laboratory tests
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) T1H - Lab tests - other (non-Medicare fee schedule)
MUE 1
CCS Clinical Classification 206 - Microscopic examination (bacterial smear, culture, toxicology)
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
90 Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number.
91 Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient.
Date
Action
Notes
2011-01-01 Changed Short description changed.
2001-01-01 Changed Code description changed.
1998-01-01 Added First appearance in code book in 1998.
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