MRSA Screening Test: CPT code 87641 – Billing News

Recent data trends reveal an increasing number of physicians and facilities performing routine MRSA screening tests on patients using CPT code 87641: assays that detect methicillin resistance and identify Staphylococcus aureus using a single nucleic acid sequence.

Medicare has a comprehensive list of screening tests that may be covered under certain circumstances and intervals. Although some hospitals are screening patients prior to inpatient or outpatient hospitalization to identify carriers of methicillin resistant staphylococcus aureus as an infection control measure, additional research will be required to demonstrate whether the use of universal rapid MRSA admission screening will reduce nosocomial MRSA infection in hospitals compared to the use of alternative control measures against MRSA.

Screening tests are statutorily noncovered based on Title VIII of the Social Security Act, Section 1862(a)(1)(A) which excludes expenses incurred for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. National Government Services considers CPT code 87641 to be a test used for screening purposes for which payment will not be allowed.