2025 CPT code 87521
(Active) Effective Date: N/A Revision Date: N/A Pathology and Laboratory Procedures - Infectious Agent Antigen Detection Pathology and Laboratory Procedures > Microbiology Procedures Feed
Detects hepatitis C virus (HCV) RNA using an amplified probe technique, including reverse transcription if performed.
Modifiers 59 (distinct procedural service) and 91 (repeat clinical diagnostic lab test) are applicable under specific circumstances.Other modifiers may apply depending on the specific billing context.
Medical necessity for 87521 is established based on the patient's clinical presentation, risk factors for HCV infection, and the need for diagnosis, monitoring of viral load during treatment, or blood donor screening.
The clinical responsibility lies with the laboratory performing the test. The ordering physician is responsible for appropriate medical decision-making based on the test results.
- Pathology and Laboratory Procedures > Microbiology Procedures
- Microbiology Procedures > Infectious Agent Antigen Detection
In simple words: This lab test checks a sample (like blood) for the hepatitis C virus. It uses a special technique to quickly and accurately find the virus's genetic material.
This CPT code, 87521, represents the laboratory procedure for detecting hepatitis C virus (HCV) RNA in a patient specimen using an amplified probe technique.The technique involves making a nucleic acid sequence more readily detectable. Reverse transcription, the process of creating a DNA copy from an RNA template, is included if performed as part of the process.The test may be requested as HCV RNA RT-PCR.
Example 1: A patient presents with symptoms suggestive of acute hepatitis C.The physician orders HCV RNA RT-PCR (87521) to confirm the diagnosis and assess viral load., A patient with chronic hepatitis C is undergoing treatment.Regular monitoring of HCV RNA levels using 87521 is necessary to evaluate treatment response., A blood donor tests positive for anti-HCV antibodies.The blood bank utilizes 87521 to determine if the donor is actively infected with HCV before blood is processed.
* Physician's order specifying the test (HCV RNA RT-PCR).* Patient demographics and relevant clinical information.* Specimen collection and handling documentation adhering to laboratory protocols.* Confirmation of the specific amplified probe technique employed.* Test results including quantification of HCV RNA (if applicable).
** This code is used for testing specifically for Hepatitis C virus.Other infectious agents require different codes. Always ensure accurate test ordering and appropriate documentation to comply with regulatory and payer requirements.Consult the most current CPT codebook for any updates or changes.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: Further information on RVUs requires consultation with the specific payer's fee schedule and local Medicare conversion factors.RVUs vary based on geographic location and facility type.
- Global Days: Not applicable. This is a laboratory test, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable.This is a laboratory test and does not involve a technical component in the same way as certain procedures.
- Fee Schedule: Historical fee schedule data is not included in this response.Contact your payer for specific historical fee information.
- Specialties:Infectious Disease, Gastroenterology, Hematology, Pathology, Clinical Microbiology
- Place of Service:Laboratory