How To Use CPT Code 87535

CPT 87535 describes the detection of HIV-1 using an amplified probe technique, including reverse transcription if performed. 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 87535?

CPT 87535 can be used to detect the presence of HIV-1 in a patient’s specimen using an amplified probe technique. This test provides a definitive diagnosis of HIV-1 and can identify the microorganism more rapidly than traditional culture methods. If reverse transcription is performed during the test, it is also included in this code.

2. Official Description

The official description of CPT code 87535 is: ‘Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes reverse transcription when performed.’

3. Procedure

1. A lab receives a patient’s specimen, such as a blood serum sample, for testing.
2. The lab performs an amplified probe technique to detect the presence of HIV-1 in the specimen.
3. If reverse transcription is necessary, the lab copies a nucleotide sequence from an RNA template during DNA synthesis.
4. The lab makes the nucleic acid sequence more readily detectable, allowing for the identification of HIV-1.
5. The lab provides a definitive diagnosis of HIV-1 based on the results of the test.

4. Qualifying circumstances

CPT 87535 is used when a lab performs an amplified probe technique to detect HIV-1 in a patient’s specimen. The test is typically ordered for patients suspected of having HIV-1 infection. It is important to note that this code specifically applies to the detection of HIV-1 and not other infectious agents.

5. When to use CPT code 87535

CPT code 87535 should be used when a lab performs an amplified probe technique to detect HIV-1 in a patient’s specimen. It is appropriate to use this code when there is a clinical suspicion of HIV-1 infection and the test is ordered to confirm the diagnosis. However, this code should not be used for the detection of other infectious agents or for screening purposes.

6. Documentation requirements

To support a claim for CPT 87535, the lab must document the following information:

• Patient’s clinical suspicion of HIV-1 infection
• Details of the specimen received for testing
• Date of the test
• Results of the test indicating the presence or absence of HIV-1
• If reverse transcription was performed during the test
• Signature of the lab personnel performing the test

7. Billing guidelines

When billing for CPT 87535, ensure that the test performed is specifically for the detection of HIV-1 using an amplified probe technique. This code should not be reported for the detection of other infectious agents or for screening purposes. It is important to follow the specific guidelines provided by the payer regarding the appropriate use of this code and any additional documentation requirements.

8. Historical information

CPT 87535 was added to the Current Procedural Terminology system on January 1, 1998. Since then, there have been two code changes. On January 1, 2013, the code description was revised to specify the use of an amplified probe technique for HIV-1 detection. On January 1, 2014, the code description was further updated to include reverse transcription when performed.

9. Examples

1. A lab performs CPT 87535 to detect the presence of HIV-1 in a blood serum specimen of a patient with clinical suspicion of HIV-1 infection.
2. Using an amplified probe technique, a lab confirms the diagnosis of HIV-1 in a patient’s specimen, supporting the clinical suspicion of HIV-1 infection.
3. A lab performs CPT 87535 to detect HIV-1 in a patient’s specimen, providing a definitive diagnosis and guiding appropriate treatment decisions.
4. Using an amplified probe technique, a lab identifies the presence of HIV-1 in a blood serum sample, confirming the diagnosis of HIV-1 infection.
5. CPT 87535 is used by a lab to detect HIV-1 in a patient’s specimen, aiding in the early diagnosis and management of HIV-1 infection.
6. A lab performs CPT 87535 to detect the presence of HIV-1 in a blood serum specimen, supporting the clinical suspicion of HIV-1 infection and allowing for appropriate interventions.
7. Using an amplified probe technique, a lab confirms the presence of HIV-1 in a patient’s specimen, providing crucial information for the management of HIV-1 infection.
8. A lab performs CPT 87535 to detect HIV-1 in a patient’s specimen, assisting in the diagnosis and monitoring of HIV-1 infection.
9. Using an amplified probe technique, a lab identifies the presence of HIV-1 in a blood serum sample, confirming the diagnosis of HIV-1 infection and enabling appropriate care.
10. CPT 87535 is used by a lab to detect HIV-1 in a patient’s specimen, aiding in the identification and management of HIV-1 infection.