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2025 CPT code 87624

Detects high-risk human papillomavirus (HPV) types using nucleic acid (DNA or RNA) testing.

Refer to CPT guidelines for microbiology procedures.Note that when both low and high-risk HPV types are tested together, code 87624 is the only code used.

Modifiers 59 (distinct procedural service) and 91 (repeat test on the same day) may be applicable depending on the specific clinical scenario.Consult CPT guidelines.

Medical necessity for this test is established based on guidelines for cervical cancer screening (age, risk factors, previous abnormal results) or in the context of evaluating abnormal Pap smears or genital lesions.Specific payer requirements should always be consulted.

The clinical responsibility lies with the laboratory personnel who perform the HPV nucleic acid detection test. The ordering physician is responsible for clinical interpretation of the results and patient management.

IMPORTANT:For low-risk HPV types, use CPT code 87623. For types 16 and 18 only (and type 45 if present), use CPT code 87625. When both low-risk and high-risk HPV types are tested in a single assay, only code 87624 is used.

In simple words: This lab test checks for the presence of high-risk types of the human papillomavirus (HPV), a virus linked to cervical and other cancers. The test uses a method to detect the virus's genetic material (DNA or RNA).

This CPT code, 87624, represents the laboratory procedure for detecting high-risk types of human papillomavirus (HPV) through nucleic acid (DNA or RNA) analysis.The test identifies the presence of specific high-risk HPV types, such as 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68, known to be associated with an increased risk of cervical cancer and other genital malignancies. The method employed involves nucleic acid amplification techniques to detect the viral DNA or RNA.This test is distinct from tests for low-risk HPV types (coded separately).

Example 1: A 30-year-old woman undergoes a routine Pap smear and HPV testing as part of her cervical cancer screening. The high-risk HPV test (87624) is positive for HPV 16., A 45-year-old woman with abnormal Pap smear results has further testing, including the high-risk HPV test (87624), which is positive for HPV 18 and 31.This finding prompts further evaluation and management., A 25-year-old sexually active woman presents with genital warts and undergoes HPV testing.The high-risk HPV test (87624) identifies HPV 52.

Patient demographics, date of service, specimen collection method, results of the HPV test (specific high-risk types detected), and the method used for HPV detection (nucleic acid amplification).

** Medicare and some other payers may have specific requirements for billing and coding this test, particularly in the context of cervical cancer screening. Always consult payer-specific guidelines.The use of this code may be subject to local coverage determinations (LCDs).

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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