How To Use CPT Code 87522

CPT 87522 describes the quantification of the hepatitis C virus using nucleic acid detection. 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 87522?

CPT 87522 can be used to measure the amount of hepatitis C virus present in a patient’s specimen, such as blood serum or plasma. This test, also known as viral load, is performed by a laboratory using the appropriate kit or device. If the laboratory also performs reverse transcription, which involves copying a nucleotide sequence from an RNA template during DNA synthesis, that service is included in this code.

2. Official Description

The official description of CPT code 87522 is: ‘Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed.’

3. Procedure

1. A laboratory receives a patient’s specimen, such as blood serum or plasma, for testing.
2. The laboratory performs quantification to measure the amount of hepatitis C virus present in the specimen using the appropriate kit or device.
3. If necessary, the laboratory also performs reverse transcription, which involves copying a nucleotide sequence from an RNA template during DNA synthesis.
4. The results of the quantification and reverse transcription, if performed, are reported to the healthcare provider.

4. Qualifying circumstances

CPT 87522 is used when a laboratory performs quantification of the hepatitis C virus in a patient’s specimen. This test is typically requested when there is a need to measure the viral load or monitor the effectiveness of treatment for hepatitis C. The laboratory may also perform reverse transcription as part of the testing process. It is important to note that this code specifically applies to the quantification of the hepatitis C virus and not other infectious agents.

5. When to use CPT code 87522

CPT code 87522 should be used when a laboratory performs quantification of the hepatitis C virus in a patient’s specimen. This test is appropriate when there is a clinical need to measure the amount of the virus present, such as monitoring the viral load or assessing the response to treatment. It is important to ensure that the test is specifically for hepatitis C and not for other infectious agents.

6. Documentation requirements

To support a claim for CPT code 87522, the laboratory should document the following information:

• Patient’s information, including name and unique identifier
• Date and time of specimen collection
• Specimen type, such as blood serum or plasma
• Details of the quantification and reverse transcription procedures performed
• Results of the quantification and reverse transcription, if performed
• Signature of the laboratory personnel performing the test

7. Billing guidelines

When billing for CPT code 87522, ensure that the laboratory has performed quantification of the hepatitis C virus in the patient’s specimen. If reverse transcription was also performed, it should be included in the billing. It is important to follow the specific guidelines provided by the payer regarding the appropriate use of this code and any additional documentation requirements. It is also important to note that CPT code 87522 should not be reported if other codes, such as CPT codes 87520-87521, have already been performed in the previous seven days.

8. Historical information

CPT code 87522 was added to the Current Procedural Terminology system on January 1, 1998. There have been two changes to the code since its addition. On January 1, 2013, the code description was updated to specify that it includes quantification of the hepatitis C virus. On January 1, 2014, the code description was further updated to include reverse transcription when performed.

9. Examples

1. A laboratory performs quantification of the hepatitis C virus in a patient’s blood serum specimen to monitor the effectiveness of antiviral treatment.
2. A healthcare provider requests quantification of the hepatitis C virus in a patient’s plasma specimen to assess the viral load before initiating treatment.
3. A laboratory performs quantification of the hepatitis C virus in a patient’s blood specimen to determine the need for further diagnostic testing.
4. A healthcare provider orders quantification of the hepatitis C virus in a patient’s serum specimen to monitor disease progression.
5. A laboratory performs quantification of the hepatitis C virus in a patient’s plasma specimen to evaluate the response to a new antiviral therapy.
6. A healthcare provider requests quantification of the hepatitis C virus in a patient’s blood specimen to assess the risk of transmission to others.
7. A laboratory performs quantification of the hepatitis C virus in a patient’s serum specimen to confirm the presence of an active infection.
8. A healthcare provider orders quantification of the hepatitis C virus in a patient’s plasma specimen to determine the appropriate treatment regimen.
9. A laboratory performs quantification of the hepatitis C virus in a patient’s blood specimen to monitor the viral load during treatment.
10. A healthcare provider requests quantification of the hepatitis C virus in a patient’s serum specimen to assess the need for liver transplantation.