How To Use CPT Code 87529

CPT 87529 describes the detection of Herpes simplex virus (HSV) using an amplified nucleic acid probe 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 87529?

CPT 87529 can be used to detect the presence of Herpes simplex virus (HSV) using an amplified nucleic acid probe technique. This code is used when a lab analyst performs a test on a specimen from a direct source, such as vesicle fluid, cerebrospinal fluid (CSF), tissue, urine, or blood, and uses amplification techniques, such as polymerase chain reaction (PCR), to assess the presence of HSV. The lab analyst uses a nucleic acid probe, which is a fabricated single strand sequence of DNA or RNA, to join with the complementary sequence in the specimen through a process called hybridization. The presence of amplified nucleic acid sequences indicates the presence of HSV.

2. Official Description

The official description of CPT code 87529 is: ‘Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique.’

3. Procedure

1. The lab analyst processes the specimen from a direct source, such as vesicle fluid, CSF, tissue, urine, or blood.
2. The lab analyst performs amplification techniques, such as PCR, to increase the number of copies of a specific target nucleic acid sequence.
3. The lab analyst assesses the presence of amplified nucleic acid sequences that indicate the presence of HSV using a nucleic acid probe.
4. The nucleic acid probe joins with the complementary sequence in the specimen through hybridization.
5. The lab analyst visualizes the hybridization product using a label, such as a radioactive or chemical tag, attached to the nucleic acid probe.
6. The lab analyst determines the presence of HSV based on the visualization of the hybridization product.

4. Qualifying circumstances

CPT 87529 is used to detect the presence of Herpes simplex virus (HSV) in a specimen. This test is typically ordered by clinicians to diagnose HSV infection. HSV causes clusters of blisters, or vesicles, on different parts of the body and spreads through person-to-person contact. The test can be performed on specimens such as vesicle fluid, CSF, tissue, urine, or blood. It is important to note that CPT 87529 is specific to the amplified probe technique for HSV detection and should not be confused with other codes for direct probe or quantification tests for HSV.

5. When to use CPT code 87529

CPT code 87529 should be used when a lab analyst performs an amplified nucleic acid probe technique to detect the presence of Herpes simplex virus (HSV) in a specimen. This code is appropriate when the test is ordered to diagnose HSV infection. It is important to use this code specifically for the amplified probe technique and not for other types of HSV tests.

6. Documentation requirements

To support a claim for CPT 87529, the following documentation is required:

• Specimen source (e.g., vesicle fluid, CSF, tissue, urine, blood)
• Amplification technique used (e.g., PCR)
• Presence of amplified nucleic acid sequences indicating HSV presence
• Details of the nucleic acid probe used for hybridization
• Visualization of the hybridization product
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 87529, ensure that the test is performed using the amplified nucleic acid probe technique for Herpes simplex virus (HSV) detection. It is important to distinguish between codes for direct probe, amplified probe, and quantification tests for HSV. Additionally, be aware that some payers may separately reimburse for specimen collection using a different code, such as 36415 for venous blood collection. It is recommended to review payer-specific guidelines for accurate billing.

8. Historical information

CPT 87529 was added to the Current Procedural Terminology system on January 1, 1998. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs an amplified nucleic acid probe technique to detect the presence of Herpes simplex virus (HSV) in vesicle fluid from a patient with suspected HSV infection.
2. Using the amplified probe technique, the lab analyst assesses the presence of HSV in cerebrospinal fluid (CSF) from a patient with symptoms of herpes virus encephalitis.
3. Amplified nucleic acid probe technique is used to detect HSV in tissue samples from a patient with suspected HSV-related lesions.
4. A lab analyst performs the amplified probe technique on urine samples to diagnose HSV infection in a patient with genital symptoms.
5. Using the amplified nucleic acid probe technique, the lab analyst detects the presence of HSV in blood samples from a patient with systemic symptoms.
6. A lab analyst performs the amplified probe technique on vesicle fluid samples to confirm HSV infection in a patient with recurrent outbreaks.
7. Amplified nucleic acid probe technique is used to detect HSV in tissue samples from a patient with suspected HSV-related eye infection.
8. A lab analyst performs the amplified probe technique on urine samples to diagnose HSV infection in a patient with atypical genital symptoms.
9. Using the amplified nucleic acid probe technique, the lab analyst detects the presence of HSV in blood samples from a patient with suspected disseminated HSV infection.
10. A lab analyst performs the amplified probe technique on vesicle fluid samples to confirm HSV infection in a patient with suspected neonatal herpes.