How To Use CPT Code 87340

CPT 87340 is a code used for detecting hepatitis B surface antigen (HBsAg) through immunoassay techniques. This article will cover topics such as the description, procedure, qualifying circumstances, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 87340.

1. What is CPT 87340?

CPT 87340 is a code used in medical billing and coding to represent a specific laboratory test for detecting the presence of hepatitis B surface antigen (HBsAg) in a patient’s blood sample. This test is performed using immunoassay techniques such as enzyme immunoassay (EIA), enzyme-linked immunosorbent assay (ELISA), fluorescence immunoassay (FIA), or immunochemiluminometric assay (IMCA). The results of this test can help healthcare providers diagnose or rule out hepatitis B infection in patients.

2. 87340 CPT code description

The official description of CPT code 87340 is: “Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; hepatitis B surface antigen (HBsAg).”

3. Procedure

  1. A blood sample is collected from the patient, typically through venipuncture.
  2. The sample is prepared for testing, which may involve separating the serum or plasma from the blood cells.
  3. The immunoassay technique is performed, using one of the methods mentioned in the code description (EIA, ELISA, FIA, or IMCA).
  4. The presence of hepatitis B surface antigen (HBsAg) is assessed in the sample, with results being either qualitative (positive or negative) or semiquantitative (providing an approximate concentration of the antigen).
  5. The test results are interpreted by a healthcare provider to determine the patient’s hepatitis B infection status.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 87340 services include those who present with symptoms suggestive of hepatitis B infection, have a history of exposure to the virus, or are at risk for contracting the disease due to certain behaviors or medical conditions. Healthcare providers may also order this test as part of routine screening for individuals in high-risk populations, such as healthcare workers, intravenous drug users, or those with multiple sexual partners.

5. When to use CPT code 87340

It is appropriate to bill the 87340 CPT code when a healthcare provider orders a laboratory test to detect the presence of hepatitis B surface antigen (HBsAg) in a patient’s blood sample using immunoassay techniques. This test is typically used to diagnose or rule out hepatitis B infection, monitor the progress of the disease, or determine the effectiveness of treatment.

6. Documentation requirements

To support a claim for CPT 87340, the following information should be documented in the patient’s medical record:

  • Patient’s demographic information, including name, date of birth, and insurance information.
  • Relevant medical history, including risk factors for hepatitis B infection and any previous testing or treatment for the disease.
  • Clinical presentation, including symptoms and physical examination findings suggestive of hepatitis B infection.
  • Rationale for ordering the HBsAg test, including the specific immunoassay technique used.
  • Test results, including the qualitative or semiquantitative assessment of HBsAg in the patient’s blood sample.
  • Interpretation of the test results by the healthcare provider, including any subsequent diagnostic or treatment decisions.

7. Billing guidelines

When billing for CPT code 87340, it is important to follow the specific guidelines and rules set forth by the payer. Some payers may reimburse separately for the specimen collection, such as venipuncture, using code 36415. If the test is performed using a different method than immunoassay, a more specific code should be used, such as 87516 or 87517. For tests detecting antibodies to hepatitis B, use code 86706 instead of 87340. This code should only be used for primary source specimens and not for testing culture isolates. If the test is performed for different species, strains, or organisms, each test should be reported separately with modifier 59, Distinct procedural service.

8. Historical information

CPT 87340 was added to the Current Procedural Terminology system on January 1, 1998. Since then, there have been several updates to the code description, with the most recent change occurring on January 1, 2022.

9. Similar codes to CPT 87340

Five similar codes to CPT 87340 and how they differ are:

  1. CPT 86706: This code is used for detecting hepatitis B surface antibody (HBsAb) instead of the surface antigen (HBsAg).
  2. CPT 87516: This code is used for detecting hepatitis B virus DNA by direct probe technique, which is a different method than immunoassay.
  3. CPT 87517: This code is used for detecting hepatitis B virus DNA by amplified probe technique, another method distinct from immunoassay.
  4. CPT 87140: This code is used for culture typing of an infectious agent, which is different from detecting antigens in a primary source specimen.
  5. CPT 87467: This code is used for quantitative detection of hepatitis B surface antigen (HBsAg), providing a precise measurement of the antigen concentration in the sample.

10. Examples

Here are 10 detailed examples of CPT code 87340 procedures:

  1. A patient presents with symptoms of acute hepatitis B infection, such as jaundice, fever, and fatigue. The healthcare provider orders an HBsAg test using the ELISA technique.
  2. A healthcare worker with a needlestick injury undergoes testing for hepatitis B exposure, including an HBsAg test using the EIA method.
  3. An individual with a history of intravenous drug use is screened for hepatitis B infection using an HBsAg test with the FIA technique.
  4. A pregnant woman is tested for hepatitis B infection as part of routine prenatal care, with an HBsAg test performed using the IMCA method.
  5. A patient with chronic hepatitis B infection undergoes an HBsAg test using the ELISA technique to monitor the effectiveness of antiviral treatment.
  6. An individual who has recently traveled to a country with a high prevalence of hepatitis B infection is tested for the disease using an HBsAg test with the EIA method.
  7. A patient with a history of multiple sexual partners undergoes hepatitis B screening, including an HBsAg test using the FIA technique.
  8. An individual with human immunodeficiency virus (HIV) infection is tested for hepatitis B coinfection using an HBsAg test with the IMCA method.
  9. A patient with liver cirrhosis of unknown etiology undergoes testing for possible hepatitis B infection, including an HBsAg test using the ELISA technique.
  10. An individual who has received a hepatitis B vaccine undergoes an HBsAg test using the EIA method to assess the immune response to the vaccine.

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