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The CPT® Code 87390 refers to the detection of the human immunodeficiency virus (HIV) antigen through various immunoassay techniques. This procedure involves testing a blood or saliva sample to identify the presence of HIV-1 antigens, which are proteins produced by the virus. The immunoassay techniques utilized in this process include enzyme immunoassay (EIA), enzyme-linked immunosorbent assay (ELISA), fluorescence immunoassay (FIA), and immunochemiluminometric assay (IMCA). These methods are designed to detect even minute quantities of the HIV antigen when it is bound to its specific antibody in the sample. The significance of this testing lies in its ability to identify HIV infections, which can be transmitted through sexual contact, unscreened blood transfusions, shared needles, and from mother to child during pregnancy or breastfeeding. HIV primarily targets the immune system by destroying T cells, also known as CD4 cells, which are crucial for the body’s defense against infections. If left untreated, HIV can progress to acquired immunodeficiency syndrome (AIDS), the most severe phase of the infection. During the testing process, a sample is collected and either placed in a fixative or sent fresh to a laboratory for analysis. The EIA and ELISA techniques work by adding a secondary enzyme-labeled antibody to the sample, which binds to the HIV antigen. A chromogenic reaction occurs, resulting in a visible color change or fluorescence that indicates the presence of the antigen. The qualitative and semi-quantitative results are determined through colorimetric readings. The FIA method employs a fluorescent compound to detect the binding of the detection antibody to the analyte molecule, while the IMCA method utilizes antibodies labeled with a chemiluminescent substance to identify and quantify the antigen-antibody complex through light emission. It is important to note that CPT® Code 87390 is specifically used for testing HIV-1 alone, while other codes are designated for testing HIV-1 with HIV-2 antibodies or HIV-2 alone.
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The procedure associated with CPT® Code 87390 is indicated for the detection of HIV-1 antigens in patients who may be at risk for HIV infection. The following conditions and situations warrant the use of this testing:
The procedure for CPT® Code 87390 involves several key steps to ensure accurate detection of HIV-1 antigens. The following outlines the procedural steps:
After the procedure associated with CPT® Code 87390, the laboratory will provide the results to the healthcare provider. It is essential for the provider to discuss the results with the patient, including the implications of a positive or negative test result. If the test is positive, further confirmatory testing may be required, and the patient should be counseled on the next steps for treatment and care. Additionally, patients may need to be informed about preventive measures and the importance of regular follow-up testing. If the test is negative, the provider may discuss ongoing risk reduction strategies and the potential need for future testing, especially if the patient remains at risk for HIV exposure.
| Short Descr | HIV-1 AG IA | Medium Descr | IAAD IA HIV-1 | 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 | 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) |
| 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | SA | Nurse practitioner rendering service in collaboration with a physician |
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Action
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Notes
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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 |
| 2011-01-01 | Changed | Short description changed. |
| 2007-01-01 | Changed | Code description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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