Pathology/Lab Avg. $6

CPT 87804: Influenza Virus Antigen, Single

Laboratory immunoassay testing for detection of influenza virus antigen (Type A or B) in respiratory specimen including nasopharyngeal swab, nasal aspirate, or throat swab.

Why CPT 87804 Claims Get Denied

Claims billed under CPT 87804 are frequently denied or downcoded for the following reasons. Understanding these patterns helps your practice reduce denial rates and recover revenue faster.

Testing outside appropriate time frame

Lack of respiratory symptoms documentation

Seasonal appropriateness questioned

Duplicate testing within short interval

Billing Tips for CPT 87804

Document respiratory symptoms supporting influenza testing. Note timing (typically first 3-4 days of illness for best accuracy). Include specimen type collected. Document clinical impact of testing on treatment decisions.

Documentation Requirements

To support a clean claim for CPT 87804, your clinical documentation should include:

Respiratory symptoms documented

Symptom onset date

Specimen type collected

Test results

Clinical interpretation

Treatment plan if positive

Antiviral therapy status

Common Modifiers for CPT 87804

Modifier 25

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