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BETA v.3.0

2025 CPT code 87536

Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when performed.

For multiple specimens/sites use modifier 59. For repeat laboratory tests performed on the same day, use modifier 91.

Modifiers 59 and 91 can be used.

Medically necessary for monitoring HIV-1 infection and treatment effectiveness.

The laboratory performs the test using a patient specimen, such as blood serum. The procedure includes reverse transcription when performed.

In simple words: This test measures the amount of HIV in your blood. It's called a viral load test and helps doctors check how well your treatment is working.

This code represents a laboratory test that quantifies the amount of HIV-1 RNA present in a patient's specimen. This test is commonly referred to as the HIV viral load test and aids in monitoring disease progression and treatment effectiveness. The process often includes reverse transcription, converting RNA to DNA for analysis.

Example 1: A patient with a recent HIV diagnosis needs a baseline viral load measurement to guide treatment decisions., A patient undergoing antiretroviral therapy requires regular viral load monitoring to assess treatment efficacy and detect potential drug resistance., A patient with an undetectable viral load may need periodic testing to confirm continued viral suppression.

The documentation should include the patient's diagnosis, the reason for the test, the date of specimen collection, and the type of specimen collected. 

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