CPT CODEPathology/LabStatus X

CPT Code 87492Complete Billing & Coding Guide (2026)Chlmyd trach dna quant

Reviewed by AAPC-Certified Coders2026 Medicare Fee ScheduleCMS + AMA Sources
Medicare Payment
$0
Non-facility · National avg
Facility
$0
Total RVU
0.00
Global
XXX
Payment
$0
non-facility
Work RVU
0.00
physician effort
Global Period
XXX
no post-op
Bundling Edits
10
NCCI pairs

About CPT 87492

CPT 87492 is a Current Procedural Terminology code in the Pathology/Lab category maintained by the American Medical Association. The CMS short descriptor reads "Chlmyd trach dna quant". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

Documentation specificity, correct ICD-10 linkage, and modifier accuracy determine whether 87492 pays cleanly or triggers a denial. Verify CMS National Physician Fee Schedule status, applicable Medicare LCDs, and any payer-specific medical policies before submission.

Pro Tip

87492 has 10 NCCI bundling edit pairs documented. Run your scrubber against the NCCI quarterly update before submission. When clinically warranted, use modifier 59 or the X-modifiers (XE, XS, XP, XU) to bypass an indicator-1 edit, with chart documentation supporting the distinct service.

Code Properties

Global Period
XXX
Not applicable (E/M, diagnostic, etc.)
Status Indicator
X
Statutorily excluded.
Conversion Factor
$33.4009
CMS national rate
Effective Date
2026-04-01
per CMS publication

RVU Breakdown

Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.

RVU Composition
0.00 total RVU
Work RVU
0.00 · 0%
Physician time + skill
Practice Expense
0.00 · 0%
Office & equipment
Malpractice
0.00 · 0%
Liability insurance
Non-Facility
Private office · urgent care · ambulatory
Most billed
$0.00
0.00 RVU × $33.4009 CF
Facility
Hospital · ASC · nursing home
$0.00
0.00 RVU × $33.4009 CF

Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.

NCCI Bundling Edits

10 pairs

These codes trigger National Correct Coding Initiative edits when billed with 87492. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.

Common Denial Risk

Billing 87492 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.

AR Recovery Note

Bundling denials on 87492 are recoverable when the edit indicator is 1 and the chart documents a distinct, separately identifiable service. Our coders verify the indicator and pick the precise X-modifier (XE, XS, XP, XU) instead of defaulting to modifier 59.

Applicable Modifiers

Modifiers commonly paired with 87492 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.

26
Professional component — physician interpretation/report only (no technical component)
When to use · When the physician only interprets/reads a diagnostic test performed by another entity (e.g., reading an echo performed at a hospital).
33
Preventive services — when the primary purpose is delivery of an evidence-based service per USPSTF A or B recommendation
When to use · Screening services (colonoscopy, mammography, etc.) to indicate the primary purpose is preventive. Waives cost-sharing under ACA.
76
Repeat procedure or service by same physician
When to use · When the same physician repeats the exact same procedure on the same day (e.g., repeat EKG after treatment, repeat X-ray after reduction).
77
Repeat procedure by another physician
When to use · When a different physician repeats the same procedure on the same day.
91
Repeat clinical diagnostic laboratory test on the same day for the same patient
When to use · When the same lab test is repeated on the same day for clinical reasons (not equipment malfunction).
GA
Waiver of liability statement issued as required by payer policy (ABN on file)
When to use · Medicare: when an Advance Beneficiary Notice (ABN) has been signed by the patient for services that may not be covered.
GY
Item or service statutorily excluded or does not meet the definition of any Medicare benefit
When to use · Service is never covered by Medicare (e.g., cosmetic procedures). May bill patient directly.
GZ
Item or service expected to be denied as not reasonable and necessary — no ABN on file
When to use · When a service is expected to be denied by Medicare and no ABN was obtained. Provider cannot bill the patient.
AR Recovery Note

Component split modifiers (26 professional, TC technical) are the most under-applied modifiers in diagnostic billing. Practices that bill global on services where they only provided the read silently invite refund requests. We split components correctly at submission.

Supporting ICD-10 Diagnoses

These diagnosis codes commonly support medical necessity for CPT 87492. Using the correct ICD-10 prevents CARC 50 denials. Payer rejects when the diagnosis doesn’t support the procedure.

1
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
CMS LCD
A00.0See ICD-10-CM tabular index
A00.1See ICD-10-CM tabular index
A00.9See ICD-10-CM tabular index
A01.00See ICD-10-CM tabular index
A01.01See ICD-10-CM tabular index
A01.02See ICD-10-CM tabular index
A01.03See ICD-10-CM tabular index
A01.04See ICD-10-CM tabular index
A01.05See ICD-10-CM tabular index
A01.09See ICD-10-CM tabular index
A01.1See ICD-10-CM tabular index
A01.2See ICD-10-CM tabular index
AR Recovery Note

CARC 50 medical-necessity denials carry both rework cost and an audit-risk signal when patterns repeat. Our coders verify ICD-10 specificity and policy alignment at the coding stage so these losses get prevented upstream.

Free 90-Day AR Recovery Audit

Find the revenue leakage in your 87492 claims.

Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Pathology/Lab claims. Our AAPC-certified team audits your last 90 days of 87492 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.

Claim my audit
FREE 90-DAY AR RECOVERY AUDIT

Losing revenue on CPT 87492? We’ll find it.

We audit your last 90 days of claims and surface the recoverable revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.

Get Your Free Billing Assessment

Free audit, no obligation. We'll review your billing and show you exactly where revenue is leaking.

98%+ clean claim rate
2.49% starting rate
Results in 30 days

Fill in your details and we'll call you back

Or call directly:888-701-6090
FAQ

Everything about CPT 87492

What does CPT code 87492 cover?

CPT 87492 is a Current Procedural Terminology code in the Pathology/Lab category maintained by the American Medical Association. The CMS short descriptor reads "Chlmyd trach dna quant". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

What is the Medicare payment for CPT 87492?

The national average Medicare payment for CPT 87492 is approximately $0 in a non-facility setting and $0 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 0 with a conversion factor of $33.4009.

What is the global period for CPT 87492?

CPT 87492 has no global period (indicator XXX). There are no post-operative day restrictions tied to this code. Refer to CMS National Physician Fee Schedule rules and any applicable NCCI edits when billing on the same date as other services.

What codes bundle with CPT 87492?

CPT 87492 has NCCI Procedure-to-Procedure edits with 10+ codes including 80503, 80504, 80505. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.

CMS Medicare Physician Fee ScheduleNCCI Edits · Current QuarterAMA CPT Code Set

CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.

Free 90-Day AR Recovery Audit

We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.