Diagnostic Restrictions for Chlamydia Trachomatis and Neisseria Gonorrhoeae

Effective for dates of service on or after April 1, 2014, additional diagnostic restrictions for CPT code 87491 (Chlamydia trachomatis, amplified probe technique) and CPT code 87591 (Neisseria gonorrhoeae, amplified probe technique) testing are required on Family PACT (Planning, Access, Care and Treatment) claims unless otherwise noted. Additionally, CPT code 87081 (culture, presumptive, pathogenic organisms, screening only) will no longer be covered for Neisseria gonorrhea (GC) screening. CT and GC diagnostic testing ICD-9-CM codes 099.52, 098.6, 098.7 and 615.0 are no longer reimbursable for Family PACT patients.