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BETA v.3.0

2025 CPT code 86703

Antibody; HIV-1 and HIV-2, single result. This test detects antibodies to HIV-1 or HIV-2, and does not differentiate between the two.

Modifier 92 may be appended if the test is performed using a single-use, disposable analytical chamber. Modifier 33 may be used for preventive services.

Yes, modifiers can be applied.Modifier 92 is used when the test is performed using a single-use, disposable analytical chamber. Modifier 33 is used for preventative screenings.

Medical necessity for this test is based on the patient's risk factors for HIV infection or the presence of symptoms suggestive of HIV.This may include history of IV drug use, unprotected sex, or symptoms like fever, night sweats, or weight loss.

The lab analyst performs the technical steps of the immunoassay, including reacting the specimen with test antigens, incubating the mixture, adding a detection agent, and interpreting the results.

IMPORTANT:For HIV-1 antigen(s) with HIV-1 and HIV-2 antibodies, use 87389. For HIV-1 antigen, use 87390. For HIV-2 antigen, use 87391. For confirmatory HIV antibody tests (e.g., Western Blot), use 86689.For CLIA-waived testing, consider HCPCS code G0433.

In simple words: This blood test checks for antibodies to HIV, the virus that causes AIDS.It gives a single result telling whether or not antibodies are present. A positive result doesn't necessarily mean you have HIV, but more tests will be needed.

This test is a qualitative or semiquantitative immunoassay for detecting antibodies to HIV-1 or HIV-2. It is typically performed on a serum specimen and provides a single result indicating the presence or absence of antibodies to either virus, without differentiating between them.It does not test for the antigens themselves. This test is often used as an initial screening for HIV infection.If positive, further testing is required to confirm the diagnosis and differentiate between HIV-1 and HIV-2.

Example 1: A patient with risk factors for HIV, such as unprotected sex or intravenous drug use, undergoes routine screening., A pregnant woman is tested for HIV as part of prenatal care., A patient presents with symptoms suggestive of HIV infection, such as fever, swollen lymph nodes, and fatigue.

Documentation should include the reason for testing, the type of specimen collected, the date of the test, and the result.

** As of 2023-05-02, some payers may prefer HCPCS code G0433 for CLIA-waived HIV tests.Always check with the specific payer for coverage and coding guidelines. While 86703 can be used for rapid tests, some payers require specific modifiers or codes for these.Ensure accurate coding to prevent claim denials.

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