2025 HCPCS code G0432
(Active) Effective Date: N/A Revision Date: N/A Laboratory Procedure - Infectious Disease Screening Laboratory Screening Tests Feed
Infectious agent antibody detection by enzyme immunoassay (EIA) technique, HIV-1 and/or HIV-2, screening.
Modifiers may be applicable depending on the circumstances of service; consult the appropriate modifier guidelines.
Medical necessity is established based on the patient's risk factors for HIV infection, as determined by the physician or qualified healthcare professional.This can include age, sexual practices, intravenous drug use, or other relevant factors.Preventive screening is often covered by insurance based on public health guidelines.
The clinical responsibility lies with the physician or qualified healthcare professional who orders and interprets the test results. This includes pre- and post-test counseling, and ordering confirmatory tests if the screening is positive.
In simple words: This code covers a blood test to check for HIV antibodies.It's a screening test, meaning a positive result needs to be confirmed with another test.
This HCPCS code, G0432, represents the performance of an enzyme immunoassay (EIA) to screen for the presence of HIV-1 and/or HIV-2 antibodies.The procedure involves a multiple-step method for qualitative or semi-quantitative detection of antibodies indicating potential HIV infection.A positive result necessitates further confirmatory testing to establish a definitive diagnosis.
Example 1: A 25-year-old male presents to a family medicine clinic for a routine physical.As part of the preventive health assessment, the physician orders an HIV screening test using EIA methodology (G0432)., A 38-year-old female who is pregnant attends a prenatal visit.The physician orders HIV screening (G0432) as part of standard prenatal care., A 45-year-old male patient with a history of intravenous drug use attends an infectious disease clinic. The physician orders HIV screening using G0432 to monitor for potential infection.
Patient demographics, date of service, test results, physician's order, and any relevant clinical notes regarding risk factors, patient counseling, and follow-up care.
** G0432 should be used for conventional EIA HIV screening tests.Other G-codes exist for ELISA and rapid tests. Always ensure proper documentation and adherence to payer guidelines for accurate billing.
- RVU: RVUs vary by payer and location. Consult your local Medicare Administrative Contractor (MAC) for specific values.
- Global Days: Not applicable; this is a laboratory test.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Historical fee schedules vary by payer and year. Check with your payer for historical data.
- Specialties:Infectious Disease, Family Medicine, Internal Medicine, Obstetrics and Gynecology
- Place of Service:Office, Clinic, Hospital Outpatient, Urgent Care