Sexually transmitted infection CPT code bundling policy change
CareOregon is implementing a new policy to bundle sexually transmitted infection (STI) testing CPT codes as part of the laboratory panel group to align with industry standard payer practices. This policy does not change how STI codes should be billed; it only impacts how claims are processed for payment.
Effective August 1, 2026, when two or more STI nucleic acid amplification testing (NAAT) laboratory CPT codes are submitted by the same provider for the same date of service for the same member, CareOregon will bundle those services into the comprehensive laboratory procedure code 87801. This change applies to CareOregon/Health Share CCO, Jackson Care Connect CCO, Columbia Pacific CCO, and CareOregon Advantage.
This policy applies to the following codes:
Single STI CPT codes
- 87491 – IADNA Chlamydia trachomatis, amplified probe technique
- 87591 – IADNA Neisseria gonorrhoeae, amplified probe technique
- 87661 – IADNA Trichomonas vaginalis, amplified probe technique
Comprehensive CPT Code
- 87801 – Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique
This bundling logic is applied during claims adjudication for both professional and facility claims.
View the policy guide on our website: https://careoregon.org/docs/default-source/providers/provider-support/coding-quick-guides/sexually-transmitted-infection-testing-policy-coding-guide.pdf?sfvrsn=b00bd7d1_3
What is not changing?
This policy does not change how providers are required to bill. Providers should continue to bill for the applicable single STI CPT codes as they are rendered, and the comprehensive CPT code will be reimbursed. This applies regardless of the number of units billed, and modifiers will not override the bundling of codes.
There will not be retroactive adjustments for claims processed prior to the effective date of August 1, 2026.
If you have any questions or require additional clarification, please contact our customer service team (option 3 for provider):
- CareOregon/Health Share of Oregon CCO: 503-416-4100 or 800-224-4840
- Jackson Care Connect CCO: 541-500-0567 or 855-722-8208
- Columbia Pacific CCO: 503-488-2822 or 855-722-8206
- CareOregon Advantage: 503-416-4279