CPT® Code 87273

Official Description

Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2

Common Language Description

The CPT® Code 87273 refers to the detection of infectious agent antigens specifically for Herpes simplex virus type 2 (HSV-2) using an immunofluorescent technique. This procedure involves testing a blood sample to identify the presence of HSV-2 antigens, which are proteins associated with the virus. The immunofluorescent technique utilizes a direct fluorescent antibody (DFA) method, which is a laboratory technique that allows for the visualization of the antigen-antibody reaction under a fluorescence microscope. Herpes simplex virus is known to be transmitted through direct contact, and the initial infection often manifests as ulcerations on the skin or mucous membranes. After the primary infection, the virus can enter a latent phase, remaining dormant in the body and potentially reactivating due to various triggers such as other illnesses, infections, or stress. Individuals at higher risk for severe complications from HSV-2 include neonates and those with compromised immune systems, as they may develop infections affecting the eyes or central nervous system. It is important to note that there are two types of herpes simplex virus: type 1 (HSV-1), which primarily causes oral herpes, and type 2 (HSV-2), which is typically associated with genital herpes. The immunofluorescent antigen detection process involves applying a specific reagent to the blood specimen, followed by incubation to facilitate the antigen-antibody reaction. After washing the specimen to eliminate any unbound conjugate, it is prepared for examination under a fluorescence microscope, where positive results are indicated by the appearance of bright green or orange-yellow fluorescence, signifying the presence of HSV-2 antigens.

1. Indications

The procedure for detecting Herpes simplex virus type 2 (HSV-2) antigens using the immunofluorescent technique is indicated for the following conditions:

Genital Herpes Symptoms Patients presenting with symptoms consistent with genital herpes, such as painful ulcerations or lesions in the genital area, may require testing to confirm the presence of HSV-2.
Ocular or CNS Infections Individuals, particularly neonates and immunocompromised patients, who exhibit signs of ocular or central nervous system infections may be tested for HSV-2 to determine if the virus is the causative agent.
Recurrent Infections Patients with a history of recurrent herpes infections may undergo testing to identify the specific type of herpes simplex virus involved in their episodes.

2. Procedure

The procedure for detecting HSV-2 antigens involves several key steps, each critical for ensuring accurate results:

Sample Collection A blood sample is obtained from the patient, which serves as the specimen for testing. Proper collection techniques must be followed to ensure the integrity of the sample.
Reagent Application A specific reagent for HSV-2 is applied to the blood specimen. This reagent contains antibodies that are designed to bind to the HSV-2 antigens if they are present in the sample.
Incubation The specimen is then incubated for a period of 15 to 30 minutes at body temperature in a humid environment. This incubation period allows sufficient time for the antigen-antibody reaction to occur, facilitating the binding of the antibodies to any HSV-2 antigens present.
Washing After incubation, the specimen is washed to remove any unbound conjugate. This step is essential to ensure that only the bound antigen-antibody complexes remain for examination.
Drying and Mounting The specimen is then dried and mounted appropriately for microscopic examination. This preparation is crucial for clear visualization of the antigen-antibody binding.
Microscopic Examination A fluorescence microscope, equipped with the appropriate fluorescent light source and barrier filters, is used to examine the specimen. The presence of antigen-antibody binding is indicated by bright green or orange-yellow fluorescence when viewed under the microscope, confirming a positive test result for HSV-2.

3. Post-Procedure

After the procedure, the specimen is analyzed, and results are typically available within a specified timeframe, depending on the laboratory's processing capabilities. If the test result is positive for HSV-2, appropriate clinical management and counseling should be provided to the patient. It is also important to consider follow-up testing or additional diagnostic procedures if necessary, especially in cases where the patient presents with severe symptoms or complications. Healthcare providers should ensure that patients are informed about the implications of the test results and the importance of ongoing management of herpes simplex virus infections.

Short Descr	HERPES SIMPLEX 2 AG IF
Medium Descr	IAADI HERPES SMPLX VIRUS TYPE 2
Long Descr	Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 2
Status Code	Statutory Exclusion (from MPFS, may be paid under other methodologies)
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
CLIA Waived (QW)	No
APC Status Indicator	Conditionally packaged laboratory tests
Type of Service (TOS)	5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS)	T1H - Lab tests - other (non-Medicare fee schedule)
MUE	1
CCS Clinical Classification	206 - Microscopic examination (bacterial smear, culture, toxicology)

90	Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number.
GA	Waiver of liability statement issued as required by payer policy, individual case