How To Use CPT Code 87912

CPT 87912 describes the analysis of the genotype of the hepatitis B virus using nucleic acid (DNA or RNA). 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 87912?

CPT 87912 can be used to describe the analysis of the genotype of the hepatitis B virus using nucleic acid (DNA or RNA). This code is used when a lab analyst performs the technical steps to determine the genetic makeup of the hepatitis B virus through nucleic acid testing. The most common specimen used for this test is serum, and the analyst may use polymerase chain reaction (PCR) to amplify the DNA or RNA in the sample. By analyzing the sequence, the analyst can determine if the virus has mutated, making it resistant to certain drugs.

2. Official Description

The official description of CPT code 87912 is: ‘Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis B virus.’

3. Procedure

1. The lab analyst performs the technical steps to analyze the genotype of the hepatitis B virus using nucleic acid testing.
2. The most common specimen used for this test is serum.
3. The analyst may use polymerase chain reaction (PCR) to amplify the DNA or RNA in the sample.
4. The analyst then joins this nucleic acid with fragments of the DNA or RNA in the standard labeled with a tag, which allows them to determine the sequencing of the hepatitis B virus.
5. By analyzing the sequence, the analyst can determine if the virus has mutated, making it resistant to certain drugs.

4. Qualifying circumstances

CPT 87912 is typically ordered when a patient has been diagnosed with hepatitis B and is resistant to the drugs used to treat it. The test helps determine if the virus has mutated, making it resistant to certain drugs. It is important to note that this test is not used to diagnose hepatitis B; it is used to determine the genotype and drug resistance of the virus.

5. When to use CPT code 87912

CPT code 87912 should be used when a lab analyst performs the analysis of the genotype of the hepatitis B virus using nucleic acid testing. It is important to ensure that the test is medically necessary and ordered for patients who have been diagnosed with hepatitis B and are resistant to the drugs used to treat it.

6. Documentation requirements

To support a claim for CPT 87912, the following documentation is typically required:

• Patient’s diagnosis of hepatitis B and resistance to treatment
• Details of the nucleic acid testing performed, including the specimen used (serum) and the method used (PCR)
• Results of the genotype analysis and any mutations detected
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT 87912, ensure that the test is medically necessary and ordered for patients who have been diagnosed with hepatitis B and are resistant to the drugs used to treat it. It is important to follow the specific guidelines provided by the payer and include all necessary documentation to support the claim. Some payers may also separately reimburse for the collection of the specimen using a different CPT code, such as 36415 for venous blood collection.

8. Historical information

CPT 87912 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A lab analyst performs the analysis of the genotype of the hepatitis B virus using nucleic acid testing to determine if the virus has mutated and become resistant to certain drugs.
2. Using serum as the specimen, the analyst amplifies the DNA or RNA in the sample using polymerase chain reaction (PCR) and analyzes the sequence to identify any mutations in the hepatitis B virus.
3. After performing the nucleic acid testing, the lab analyst determines that the patient’s hepatitis B virus has mutated, making it resistant to the drugs used to treat it.
4. Based on the genotype analysis, the lab analyst recommends alternative treatment options for the patient with drug-resistant hepatitis B.
5. The lab analyst documents the results of the genotype analysis and includes their signature to support the claim for CPT code 87912.