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BETA v.3.0

2025 CPT code 87522

This test quantifies the hepatitis C virus (HCV) RNA in a patient's serum or plasma using molecular techniques like real-time PCR. It includes reverse transcription when performed.

The molecular diagnostic codes (e.g., 81161, 81200-81408) are not to be used in combination with or instead of 87522. For multiple specimens/sites, use modifier 59. For repeat laboratory tests performed on the same day, use modifier 91. If additional molecular studies are performed (e.g., sequencing), code them separately.

Modifiers 59 and 91 are applicable to this code as described in the coding guidelines.

Medical necessity for this test is established when the patient has a confirmed or suspected active hepatitis C infection and requires quantification of the viral load for diagnostic purposes, treatment monitoring, or assessment of treatment response.

A laboratory professional performs the quantification of HCV RNA using molecular techniques. This involves extracting RNA from the patient's sample, converting it to DNA (reverse transcription if necessary), and amplifying the specific HCV genetic material to measure the viral load.

In simple words: This lab test measures the amount of hepatitis C virus in your blood. This is often called a "viral load" test. It helps doctors know how much of the virus is active in your body and is used to guide treatment decisions and check if treatment has worked.

The test measures the amount of Hepatitis C virus present in a patient specimen, such as blood serum or plasma, using the appropriate kit/device. If the lab performs reverse transcription, in which a nucleotide sequence is copied from an RNA template during DNA synthesis, that service is also included. This test may be referred to as HCV RNA quantification using the molecular technique.

Example 1: A patient with a known history of hepatitis C infection is starting antiviral treatment. The 87522 test is performed to establish a baseline viral load before treatment begins., A patient undergoing antiviral treatment for hepatitis C has follow-up 87522 tests performed at regular intervals to monitor the treatment's effectiveness and assess the viral load reduction., A patient has completed hepatitis C treatment. A follow up 87522 test is performed 12 weeks after the end of treatment to assess treatment response and confirm whether a sustained virologic response (SVR), indicating a cure, has been achieved.

The required documentation includes the patient's medical history, the reason for testing, the date and time of sample collection, the type of specimen collected (serum or plasma), and the testing methodology used.

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