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The CPT® Code 87389 refers to the detection of infectious agent antigens specifically for human immunodeficiency virus (HIV) using various immunoassay techniques. This code encompasses qualitative or semiquantitative testing methods such as enzyme immunoassay (EIA), enzyme-linked immunosorbent assay (ELISA), fluorescence immunoassay (FIA), and immunochemiluminometric assay (IMCA). The procedure involves analyzing a blood or saliva sample to identify the presence of HIV-1 antigens along with antibodies for both HIV-1 and HIV-2, providing a single result. HIV is a virus that primarily attacks the immune system by targeting T cells, also known as CD4 cells, which are crucial for the body’s defense against infections. The transmission of HIV can occur through various means, including sexual contact, sharing of needles, unscreened blood transfusions, and from mother to child during pregnancy or breastfeeding. The testing process involves collecting a sample, which is then processed in a laboratory setting. The immunoassay techniques utilized in this procedure are designed to detect even minute quantities of the HIV antigen when it binds to its specific antibody. The detection methods rely on colorimetric or fluorescent reactions to indicate the presence of the antigen-antibody complex, thus allowing for the assessment of HIV infection status. This code is specifically used when both HIV-1 antigens and HIV-1 and HIV-2 antibodies are being tested simultaneously, distinguishing it from other codes that may be used for testing HIV-1 or HIV-2 alone.
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The CPT® Code 87389 is indicated for the detection of HIV-1 antigens and the presence of HIV-1 and HIV-2 antibodies in patients who may be at risk for HIV infection. The following conditions or situations may warrant the use of this test:
The procedure for CPT® Code 87389 involves several key steps to ensure accurate detection of HIV-1 antigens and antibodies:
After the procedure, the patient may receive counseling regarding the results of the test. If the test is positive, further confirmatory testing and follow-up care will be necessary to discuss treatment options and preventive measures. Patients should also be informed about the importance of regular testing and safe practices to prevent the transmission of HIV. If the test is negative, it may still be recommended to retest after a certain period, especially if there has been recent exposure to HIV. Additionally, healthcare providers may offer resources for education and support related to HIV prevention and management.
| Short Descr | HIV-1 AG W/HIV-1&-2 AB AG IA | Medium Descr | IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE | Long Descr | Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result | 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) | Yes | 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. | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | QW | Clia waived test | GA | Waiver of liability statement issued as required by payer policy, individual case | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | GZ | Item or service expected to be denied as not reasonable and necessary | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | 33 | Preventive services: when the primary purpose of the service is the delivery of an evidence based service in accordance with a us preventive services task force a or b rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by adding 33 to the procedure. for separately reported services specifically identified as preventive, the modifier should not be used. | 92 | Alternative laboratory platform testing: when laboratory testing is being performed using a kit or transportable instrument that wholly or in part consists of a single use, disposable analytical chamber, the service may be identified by adding modifier 92 to the usual laboratory procedure code (hiv testing 86701-86703, and 87389). the test does not require permanent dedicated space, hence by its design may be hand carried or transported to the vicinity of the patient for immediate testing at that site, although location of the testing is not in itself determinative of the use of this modifier. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | KX | Requirements specified in the medical policy have been met | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | Q4 | Service for ordering/referring physician qualifies as a service exemption | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SL | State supplied vaccine | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2022-01-01 | Changed | First appearance of change in codebook. |
| 2022-01-01 | Note | Grammatical correction. |
| 2021-01-01 | Changed | First appearance of change in CPT® Code Set. |
| 2020-10-06 | Changed | Code changed. |
| 2016-01-01 | Changed | Description Changed |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2012-01-01 | Added | Added |
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