How To Use CPT Code 87903

CPT 87903 describes the analysis of nucleic acids from a tissue sample of an HIV 1 positive patient to determine drug resistance through culture analysis for up to the first 10 drugs tested. 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 87903?

CPT 87903 can be used to describe the analysis of nucleic acids from a tissue sample of an HIV 1 positive patient to determine drug resistance through culture analysis for up to the first 10 drugs tested. This code is used when the lab analyst performs the technical lab test to culture the tissue specimen and analyze the reaction of the nucleic acids to different drugs.

2. Official Description

The official description of CPT code 87903 is: ‘Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1; first through 10 drugs tested.’

3. Procedure

1. The lab analyst receives a tissue sample from an HIV 1 positive patient.
2. The analyst cultures the tissue sample on a nutrient medium that allows the HIV 1 virus to grow.
3. Multiple samples containing different drugs are placed on the culture to analyze the reaction of the nucleic acids.
4. If the nucleic acids in the HIV 1 virus are resistant to a particular drug, the virus will not grow around the sample containing that drug.
5. The lab analyst repeats the process for up to the first 10 drugs tested.

4. Qualifying circumstances

CPT 87903 is used when analyzing the nucleic acids from a tissue sample of an HIV 1 positive patient to determine drug resistance through culture analysis. This procedure is performed to identify the optimal drug regimen for the patient or to change the drug regimen if the patient is no longer benefiting from the current drugs they are taking.

5. When to use CPT code 87903

CPT code 87903 should be used when analyzing the nucleic acids from a tissue sample of an HIV 1 positive patient to determine drug resistance through culture analysis for up to the first 10 drugs tested. It is important to note that this code should not be used if more than 10 drugs are tested, as additional codes should be reported for each additional drug.

6. Documentation requirements

To support a claim for CPT 87903, the documentation should include:

• Patient’s HIV 1 positive status
• Details of the tissue sample used for analysis
• Specific drugs tested and their reactions with the nucleic acids
• Date and time of the analysis
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 87903, ensure that the analysis is performed on the nucleic acids from a tissue sample of an HIV 1 positive patient. Report this code for up to the first 10 drugs tested. If more than 10 drugs are tested, additional codes should be reported for each additional drug. It is important to follow the specific guidelines provided by the payer to ensure accurate billing.

8. Historical information

CPT 87903 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs the analysis of nucleic acids from a tissue sample of an HIV 1 positive patient to determine drug resistance through culture analysis for the first 10 drugs tested.
2. The nucleic acids in the HIV 1 virus from the tissue sample show resistance to three out of the 10 drugs tested.
3. Based on the analysis, the clinician adjusts the patient’s drug regimen to include drugs that the HIV 1 virus is not resistant to.
4. A different lab analyst performs the analysis of nucleic acids from a tissue sample of an HIV 1 positive patient to determine drug resistance through culture analysis for the first 10 drugs tested.
5. The nucleic acids in the HIV 1 virus from the tissue sample show sensitivity to all 10 drugs tested.
6. The clinician confirms that the patient’s current drug regimen is effective based on the analysis results.
7. Another lab analyst performs the analysis of nucleic acids from a tissue sample of an HIV 1 positive patient to determine drug resistance through culture analysis for the first 10 drugs tested.
8. The nucleic acids in the HIV 1 virus from the tissue sample show resistance to six out of the 10 drugs tested.
9. The clinician decides to change the patient’s drug regimen to include drugs that the HIV 1 virus is not resistant to.
10. A different lab analyst performs the analysis of nucleic acids from a tissue sample of an HIV 1 positive patient to determine drug resistance through culture analysis for the first 10 drugs tested.
11. The nucleic acids in the HIV 1 virus from the tissue sample show sensitivity to only one out of the 10 drugs tested.
12. The clinician adjusts the patient’s drug regimen to include the drug that the HIV 1 virus is sensitive to.