CPT® Code 87274

Official Description

Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1

Common Language Description

The CPT® Code 87274 refers to the detection of the Herpes simplex virus type 1 (HSV-1) antigen using an immunofluorescent technique. This procedure involves testing a blood sample to identify the presence of HSV-1, which is a virus that can cause infections primarily through direct contact. The initial infection with HSV-1 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. Certain populations, including neonates and individuals with compromised immune systems, are particularly vulnerable to severe complications, including ocular or central nervous system infections. HSV is categorized into two types: type 1, which is commonly associated with oral herpes (cold sores) but can also lead to genital infections, and type 2, which primarily causes genital herpes. The immunofluorescent antigen detection method for HSV-1 utilizes a direct fluorescent antibody (DFA) technique. In this process, a blood sample is collected, and a specific reagent for HSV-1 is applied to the specimen. The sample is then incubated in a controlled environment to facilitate the antigen-antibody reaction. Following incubation, the specimen undergoes washing to eliminate any unbound conjugate, after which it is dried and mounted for examination. A fluorescence microscope equipped with the necessary light source and filters is employed to analyze the specimen, where successful antigen-antibody binding is indicated by bright green or orange-yellow fluorescence, signifying a positive test result. For testing HSV type 2, the appropriate code is 87273, while 87274 is designated for HSV type 1.

1. Indications

The procedure for detecting Herpes simplex virus type 1 (HSV-1) antigen is indicated for the following conditions:

Primary Infection The test is performed when a patient presents with symptoms indicative of a primary HSV-1 infection, such as ulcerations in the skin or mucous membranes.
Reactivation Symptoms It is indicated for patients experiencing recurrent symptoms that may suggest reactivation of the virus, particularly in those with a history of HSV-1 infections.
High-Risk Populations The procedure is crucial for neonates and immunocompromised individuals who are at increased risk for severe complications, including ocular or central nervous system infections.

2. Procedure

The procedure for HSV-1 antigen detection by immunofluorescent technique involves several key steps:

Sample Collection A blood sample is obtained from the patient, which serves as the specimen for testing.
Reagent Application A specific reagent for HSV-1 is applied to the collected specimen. This reagent is designed to bind to the HSV-1 antigens 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 reagent to any HSV-1 antigens present.
Washing After incubation, the specimen undergoes a washing process to remove any unbound conjugate, ensuring that only the bound antigen-antibody complexes remain for examination.
Drying and Mounting The specimen is then dried and mounted, preparing it for microscopic analysis.
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, which confirms a positive test result.

3. Post-Procedure

Post-procedure care for patients undergoing HSV-1 antigen detection typically involves monitoring for any immediate reactions to the blood draw. Patients may be advised to follow up with their healthcare provider to discuss the test results and any necessary further actions based on the findings. It is important for healthcare professionals to provide education regarding the implications of a positive or negative test result, particularly in relation to the patient's symptoms and overall health status. Additionally, patients should be informed about the potential for reactivation of the virus and the importance of managing triggers that may lead to future outbreaks.

Short Descr	HERPES SIMPLEX 1 AG IF
Medium Descr	IAADI HERPES SMPLX VIRUS TYPE 1
Long Descr	Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1
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.