CPT® code 87804 is used to report the infectious agent antigen detection by immunoassay with direct optical observation for influenza. This code covers a rapid flu test commonly performed in clinics, urgent care centers, and physician offices to quickly identify the presence of influenza A or B antigens.
When to Use CPT® Code 87804
- When performing a rapid influenza diagnostic test (RIDT) using immunoassay methods.
- When the test provides direct optical observation of influenza antigens.
- May be billed once per test (e.g., 87804 x 2 if both influenza A and B are tested separately).
Billing Requirements
- Document the medical necessity for testing (e.g., patient presents with flu-like symptoms).
- Bill per antigen tested, not per sample.
- Some payers may require modifiers to distinguish between influenza A and B tests.
- Laboratory CLIA certification may be required depending on the test kit used.
Common Clinical Scenarios
- A patient presents with fever, cough, and sore throat; the provider performs a rapid flu test to determine if influenza A or B is present.
- An urgent care clinic runs a point-of-care RIDT during flu season to quickly guide treatment decisions.
- A pediatric practice screens symptomatic children with a rapid influenza test to help decide on antiviral therapy.
Simplify CPT® 87804 Documentation with OptiMantra
Accurate billing for diagnostic tests like CPT® 87804 depends on streamlined documentation, coding precision, and payer compliance. OptiMantra’s all-in-one EMR and practice management platform helps providers capture test results, apply correct codes, and submit clean claims. For urgent care, pediatrics, and integrative clinics alike, OptiMantra makes it easy to stay compliant while improving efficiency and patient care.
Try OptiMantra for free here!
.png)
