2025 CPT code 87538
Effective Date: N/A Revision Date: N/A Pathology and Laboratory Procedures > Microbiology Procedures Feed
Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes reverse transcription when performed.
Modifiers 59 and 91 are applicable to this code, as described in the coding guidelines.
Medical necessity must be established for this test by indicating the clinical rationale for testing for HIV-2 specifically. This could include symptoms, travel history to regions with higher HIV-2 prevalence, potential exposure to HIV-2, inconclusive or negative HIV-1 results, or the need for HIV-2 viral load monitoring.
Laboratory professionals are responsible for performing this test using appropriate techniques and ensuring accurate results. This includes proper specimen handling, analysis, and interpretation within established laboratory guidelines.
In simple words: This test helps determine if you have HIV-2, a type of virus that attacks the immune system. It's done in a lab by analyzing a sample, like blood, to look for specific parts of the virus's genetic material. This method is faster than waiting for the virus to grow in a lab dish.
This code represents a laboratory test that uses amplified probe technique to detect the presence of HIV-2 in a patient specimen.It includes reverse transcription when performed. This method allows for faster identification of microorganisms compared to traditional cultures by increasing the detectability of a specific nucleic acid sequence.
Example 1: A patient from West Africa presents with symptoms suggestive of HIV infection.An HIV-1 test is negative, and an HIV-2 specific nucleic acid test (87538) is ordered to definitively diagnose or rule out HIV-2 infection., A patient with known HIV-1 infection develops unusual symptoms or a decline in immune function. An HIV-2 nucleic acid test (87538) is ordered to assess for potential dual infection with both HIV-1 and HIV-2., A patient is being monitored for HIV-2 viral load after starting antiretroviral therapy. The 87538 code is used for quantifying HIV-2 RNA copies in the blood, providing valuable information on treatment response and disease progression.
Documentation should include the patient's signs and symptoms, risk factors for HIV-2 exposure, reason for testing, the specific test performed (including whether reverse transcription was necessary), the test result, and its interpretation by the ordering physician.
- Specialties:Infectious Disease, Internal Medicine, Family Medicine, Public Health
- Place of Service:Office, Independent Clinic, Hospital, Public Health Clinic