CPT® Code 87491 is used to report nucleic acid detection testing for Chlamydia trachomatis using an amplified probe technique, either qualitative or quantitative. This molecular diagnostic test is highly sensitive and specific, allowing detection of Chlamydia infection from urine, endocervical, or urethral specimens.
This code represents the laboratory test itself, not specimen collection, interpretation, or evaluation and management services, which may be billed separately.
Key Facts About CPT® 87491
- Service type: Laboratory molecular diagnostic test
- Provider type: Physicians, clinics, and qualified laboratories
- Medical services included: Yes—Chlamydia trachomatis detection
- Specimen type: Urine, endocervical, or urethral swabs
- Analytical method: Nucleic acid amplification (NAAT) with probe
- Common clinical indications:
- Screening sexually active patients for Chlamydia infection
- Evaluation of symptomatic patients with dysuria, discharge, or pelvic pain
- Monitoring response to treatment in confirmed cases
- Prenatal screening in pregnant individuals
When to Use CPT® 87491
CPT 87491 is appropriate when:
- Testing is performed for Chlamydia trachomatis detection using amplified nucleic acid probe techniques
- Specimens include urine or genital swabs
- The test is medically necessary for screening, diagnosis, or treatment follow-up
- Distinct from other STI testing (e.g., Neisseria gonorrhoeae, Trichomonas)
Examples:
- Screening a sexually active adolescent female during a routine exam
- Testing a patient with urethral discharge for Chlamydia infection
- Confirming eradication of Chlamydia after antibiotic therapy
Documentation Requirements
To support CPT 87491 billing, documentation should include:
- Patient identifiers and date of service
- Clinical indication for Chlamydia testing
- Specimen type and collection site
- Test performed (IA/DNA, amplified probe)
- Test result and date reported
- Ordering provider information
Thorough documentation ensures compliance, supports reimbursement, and guides clinical care.
Reimbursement and Coding Considerations
- CPT 87491 is typically covered by commercial payers and Medicare for medically necessary testing
- Often billed in conjunction with CPT 87591 (Neisseria gonorrhoeae) for dual STI screening
- Specimen collection may be billed separately if allowed by payer
- Payer-specific frequency limitations may apply for routine screening
- Accurate diagnosis codes (e.g., Z11.3 for screening, A56.0–A56.9 for infection) support reimbursement
How OptiMantra Supports Chlamydia Testing
OptiMantra’s integrated EMR and practice management system streamlines documentation and billing for CPT 87491:
With OptiMantra, providers can:
- Order Chlamydia IA/DNA tests directly in the patient chart
- Track specimen collection, lab submission, and results
- Link results to diagnoses, treatment plans, and follow-up instructions
- Generate compliant, audit-ready laboratory billing codes
- Maintain longitudinal STI testing records for patient care and reporting
By centralizing lab workflows, OptiMantra helps practices improve efficiency, ensure compliance, and optimize reimbursement for STI testing.
Try OptiMantra for free here!
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