CPT® code 87880 is used to report a rapid antigen detection test (RADT) for Group A Streptococcus (GAS) performed by optical (visual) observation. This code is most commonly used in outpatient settings, including primary care, pediatrics, urgent care, and integrative family medicine practices.
What is CPT Code 87880?
CPT 87880 describes a CLIA-waived, in-office rapid test that detects the presence of Group A Streptococcus—the bacteria responsible for strep throat—in a throat swab specimen. This test uses immunoassay technology and is interpreted visually, typically producing results in 5 to 10 minutes.
The test process includes:
- Collecting a throat swab from the tonsillar area and posterior pharynx
- Exposing the swab to a reagent solution designed to extract and bind the strep antigen
- Applying the sample to a test cassette or strip
- Visually observing the appearance of a test line (positive/negative)
Rapid results allow clinicians to diagnose and treat strep throat during the same visit—helping reduce unnecessary antibiotic use and improving patient outcomes.
When to Use CPT Code 87880
Use 87880 when performing a Group A strep test using optical (manual) reading. This is a qualitative, point-of-care test used when a patient presents with symptoms such as:
- Sore throat
- Fever
- Swollen lymph nodes
- Tonsillar exudates
Appropriate documentation should include:
- Clinical rationale for testing (e.g., Centor or McIsaac criteria)
- Method of specimen collection
- Results (positive or negative)
- Any follow-up actions taken (e.g., prescribing antibiotics or ordering confirmatory culture)
Coding Considerations
- CPT 87880 applies to manual interpretation only. If the test is read using an automated analyzer, a different code (e.g., 87801) may be required.
- Most payers require that the test be performed under a CLIA certificate of waiver.
- Modifier -QW is often required when billing Medicare for CLIA-waived tests.
- If both a rapid strep test (87880) and a throat culture are performed, report each separately—if medically necessary and documented.
CPT 87880 and Rapid Diagnostics in Primary Care
Quick identification of Group A strep infection allows for timely treatment and prevention of complications such as rheumatic fever. However, since strep throat symptoms overlap with viral infections, insurers often expect documentation of specific symptoms or decision-support criteria before reimbursing this code.
Clinical guidelines suggest using validated tools like Centor scoring to support the medical necessity of rapid strep testing in children and adults.
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For practices offering point-of-care diagnostics like rapid strep testing, accurate documentation, coding, and inventory management are key to efficient clinical operations and full reimbursement. OptiMantra helps by:
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