2025 CPT code 87534
Effective Date: N/A Pathology and Laboratory Procedures > Microbiology Procedures Feed
Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique
Modifiers 59 and 91 are applicable as described in the coding guidelines.
Medical necessity is determined by the patient's signs, symptoms, and risk factors for HIV infection. Testing might be medically necessary for diagnostic purposes, monitoring viral load during treatment, or screening high-risk individuals.
The laboratory analyst performs all technical steps involved in the test. This includes specimen preparation, mixing the specimen with the nucleic acid probe, and analyzing the results to determine the presence or absence of HIV-1 nucleic acid.
In simple words: This test checks for the genetic material of HIV-1 (the virus that causes most AIDS cases) in a sample like blood or spinal fluid. It uses a special "probe" that attaches to the virus's genes if they're present, making them visible to lab technicians. This allows for rapid identification of the virus.
This code represents a laboratory test for HIV-1 using a direct probe technique. The procedure involves detecting specific nucleic acid sequences (DNA or RNA) of HIV-1 in a patient specimen (e.g., serum, spinal fluid). A labeled nucleic acid probe is mixed with the prepared specimen. If the target HIV-1 sequence is present, the probe hybridizes (binds) to it. The label on the probe then allows visualization and confirms the presence of HIV-1.
Example 1: A patient with suspected acute HIV infection needs rapid confirmation of the virus' presence., Monitoring the viral load in a patient undergoing HIV treatment., Testing a newborn of an HIV-positive mother to determine the infant's infection status.
Documentation should include the patient's medical history, reason for testing, the type of specimen collected, the date of collection, and the test result. Any relevant clinical findings or diagnoses related to HIV should also be documented.
- Revenue Code: T1H
- Specialties:Infectious Disease, Pathology, Internal Medicine, Family Medicine, Pediatrics
- Place of Service:Independent Laboratory, Hospital (Inpatient or Outpatient), Physician's Office