How To Use CPT Code 87390

CPT 87390 describes the detection of antigens of the human immunodeficiency virus 1 (HIV-1) using an immunoassay technique. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 87390?

CPT 87390 can be used to detect antigens of the human immunodeficiency virus 1 (HIV-1) using an immunoassay technique. This code is used when a lab analyst performs all the necessary technical steps to assess the presence of HIV-1 antigens in a patient’s specimen, such as serum. The immunoassay technique may include methods like enzyme immunoassay (EIA), enzyme-linked immunosorbent assay (ELISA), fluorescence immunoassay (FIA), or immunochemiluminometric assay (IMCA).

2. Official Description

The official description of CPT code 87390 is: ‘Infectious agent antigen detection by immunoassay technique (eg, EIA, ELISA, FIA, IMCA), qualitative or semiquantitative; HIV-1.’

3. Procedure

1. The lab analyst performs an immunoassay technique on a primary source specimen, such as serum, from the patient.
2. The analyst assesses the presence of HIV-1 antigens, which are specific protein particles on the virus, using methods like EIA, ELISA, FIA, or IMCA.
3. The test detects circulating, replicating HIV-1 virus in the specimen, serving as an early marker for HIV-1 infection, disease progression, or therapeutic response.
4. If the test result is positive, a confirmatory test, such as a neutralization test, may be requested by clinicians.

4. Qualifying circumstances

CPT 87390 is used when clinicians order the test to detect circulating, replicating HIV-1 virus in a patient’s specimen. This test can serve as an early marker for HIV-1 infection, disease progression, or therapeutic response. It is important to note that this code is specific to HIV-1 antigen detection and should not be used for HIV-1 antibody testing or testing for other strains or species of the virus.

5. When to use CPT code 87390

CPT code 87390 should be used when a lab analyst performs an immunoassay technique to detect HIV-1 antigens in a patient’s specimen. This code is appropriate when the test is performed using methods like EIA, ELISA, FIA, or IMCA. It is important to use this code only for primary source specimens and not for testing culture isolates. Additionally, this code should not be used for HIV-1 antibody testing or testing for other strains or species of the virus.

6. Documentation requirements

To support a claim for CPT 87390, the following documentation is required:

• Patient’s information and reason for ordering the test
• Details of the immunoassay technique used, such as EIA, ELISA, FIA, or IMCA
• Date and time of the test
• Results of the test and any additional confirmatory tests performed
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 87390, ensure that the test is performed using an immunoassay technique and that it is specific to HIV-1 antigen detection. This code should not be reported for HIV-1 antibody testing or testing for other strains or species of the virus. It is important to follow the specific guidelines provided by payers and to use the appropriate modifiers if necessary.

8. Historical information

CPT 87390 was added to the Current Procedural Terminology system on January 1, 1998. There have been several changes to the code over the years, including updates to the description and the addition of modifiers.

9. Examples

1. A lab analyst performs an immunoassay technique to detect HIV-1 antigens in a patient’s serum specimen.
2. The test results show the presence of HIV-1 antigens, indicating an early marker for HIV-1 infection.
3. A confirmatory test is requested to confirm the positive result.
4. The lab analyst performs an immunoassay technique to detect HIV-1 antigens in a patient’s serum specimen, using the EIA method.
5. The test results show no presence of HIV-1 antigens, indicating a negative result.
6. A lab analyst performs an immunoassay technique to detect HIV-1 antigens in a patient’s serum specimen, using the FIA method.
7. The test results show the presence of HIV-1 antigens, indicating disease progression.
8. A confirmatory test is requested to confirm the positive result and assess the therapeutic response.
9. The lab analyst performs an immunoassay technique to detect HIV-1 antigens in a patient’s serum specimen, using the IMCA method.
10. The test results show the presence of HIV-1 antigens, indicating a therapeutic response to treatment.