How To Use CPT Code 87625

CPT 87625 describes the detection of human papillomavirus (HPV) using nucleic acid testing. 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 87625?

CPT 87625 can be used to describe the detection of human papillomavirus (HPV) using nucleic acid testing. This code is specifically used for the detection of HPV types 16 and 18, and includes type 45 if performed.

2. Official Description

The official description of CPT code 87625 is: ‘Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed.’

3. Procedure

1. The lab analyst performs a test to detect the presence of human papillomavirus using nucleic acid detection.
2. Nucleic acid probes are used to identify the specific DNA or RNA of the virus.
3. The test can detect HPV types 16 and 18, and also includes type 45 if performed.
4. The lab analyst performs the necessary technical steps to accurately detect and identify the presence of HPV.
5. The test results are analyzed and reported to the healthcare provider.

4. Qualifying circumstances

CPT 87625 is used for the detection of human papillomavirus (HPV) types 16 and 18. It may also include type 45 if performed. This test is typically performed for patients who may be at risk for HPV-related conditions, such as cervical cancer or other malignancies of the genitalia. The test is performed by a lab analyst using nucleic acid detection techniques.

5. When to use CPT code 87625

CPT code 87625 should be used when a healthcare provider orders a test specifically for the detection of HPV types 16 and 18. This code should not be used for the detection of other HPV types or for low-risk HPV types. If the test includes the detection of five or more high-risk HPV types, a different code should be used (such as 0500T).

6. Documentation requirements

To support a claim for CPT 87625, the healthcare provider must document the following information:

• Reason for ordering the HPV detection test
• Specific HPV types being tested for (16, 18, and/or 45)
• Date the test was performed
• Results of the test
• Signature of the healthcare provider ordering the test

7. Billing guidelines

When billing for CPT 87625, ensure that the test is specifically for the detection of HPV types 16 and 18. If type 45 is also performed, it should be included in the billing. Do not report CPT 87625 if the test includes the detection of five or more high-risk HPV types. It is important to follow the specific guidelines provided by the payer when submitting claims for HPV detection tests.

8. Historical information

CPT 87625 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider orders a test to detect HPV types 16 and 18 in a patient with abnormal cervical cells.
2. A patient undergoes an HPV detection test specifically for types 16 and 18 as part of routine cervical cancer screening.
3. A healthcare provider orders an HPV test for a patient with genital warts to determine if the warts are caused by HPV types 16 or 18.
4. A patient with a history of HPV-related cervical cancer undergoes regular HPV testing to monitor for recurrence, specifically for types 16 and 18.
5. A healthcare provider orders an HPV detection test for a patient with persistent high-risk sexual behavior, specifically for types 16 and 18.
6. A patient with a family history of HPV-related cancers undergoes an HPV detection test specifically for types 16 and 18 as a preventive measure.
7. A healthcare provider orders an HPV test for a patient with suspicious genital lesions, specifically for types 16 and 18.
8. A patient with a history of HPV-related throat cancer undergoes regular HPV testing to monitor for recurrence, specifically for types 16 and 18.
9. A healthcare provider orders an HPV detection test for a patient with abnormal anal cytology, specifically for types 16 and 18.