2025 CPT code 87625
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Infectious Agent Antigen Detection - Microbiology Procedures Pathology and Laboratory Procedures Feed
Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), types 16 and 18, includes type 45 if performed.
Modifiers may be applicable depending on the circumstances of service. For example, modifier 59 may be used if multiple specimens/sites are tested on the same day. Modifier 91 may be used for repeat tests performed on the same day. Consult the CPT manual and payer guidelines for specific modifier usage.
Medical necessity is established when there is a clinical indication for HPV testing, such as abnormal Pap smear results, colposcopic findings suggestive of cervical intraepithelial neoplasia (CIN), or a personal or family history of cervical cancer.Testing may also be medically necessary for post-treatment surveillance or risk stratification in high-risk populations.
The clinical responsibility lies with the laboratory analyst who performs the technical steps to detect the presence of HPV types 16, 18 and 45 using nucleic acid detection methods.The physician interprets the results and makes clinical management decisions based on the findings.
- Pathology and Laboratory Procedures
- Pathology and Laboratory Procedures > Microbiology Procedures > Infectious Agent Antigen Detection
In simple words: This lab test checks for the presence of specific types of the human papillomavirus (HPV), a virus that can cause genital warts and cancer. The test looks for types 16 and 18, and also type 45 if present.The results help doctors decide on the best course of treatment or monitoring.
This CPT code, 87625, represents the detection of Human Papillomavirus (HPV) types 16 and 18 using nucleic acid (DNA or RNA) technology.The test includes the detection of HPV type 45 if it is also present in the sample. This procedure involves the analysis of a patient's sample to identify the presence of these specific high-risk HPV types known to be associated with cervical cancer and other genital malignancies. The method employs nucleic acid probes or amplification techniques to detect the viral genetic material. Results provide crucial information for guiding clinical management decisions, particularly in cervical cancer screening and preventative measures.
Example 1: A 35-year-old female patient presents for a routine Pap smear and HPV screening.The Pap smear shows atypical squamous cells of undetermined significance (ASC-US).The HPV test (87625) is ordered to assess for the presence of high-risk HPV types., A 28-year-old female patient with a history of abnormal Pap smears undergoes colposcopy. Biopsies are taken, and the HPV test (87625) is ordered to aid in risk stratification and treatment planning., A 40-year-old female patient presents with abnormal vaginal bleeding.To evaluate the possibility of cervical cancer, a Pap smear and HPV test (87625) are ordered to aid in diagnosis.
* Patient demographics and identification information.* Date of service.* Specimen type and collection method.* Indication for testing (e.g., abnormal Pap smear, risk assessment).* Test result report, including specific HPV types detected.* Physician's order for the test.
** Always refer to the most current CPT codebook and payer guidelines for accurate coding and reimbursement. The information provided is for educational purposes only and should not be considered medical advice.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: Information not available in provided text.RVUs vary based on geographic location and other factors. Consult the appropriate fee schedule for current values.
- 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; a technical component modifier is not relevant.
- Fee Schedule: Fee schedules vary by payer and geographic location.Historical fee data is not provided here, but can be found through your billing system and payer-specific resources. Remember to check for updates as fee schedules change over time.
- Specialties:* Obstetrics and Gynecology* Pathology* Family Medicine
- Place of Service:* Office* Hospital outpatient* Clinical laboratory* Other