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The CPT® Code 87517 refers to a laboratory test specifically designed for the detection and quantification of the hepatitis B virus (HBV) through nucleic acid analysis, which can involve either DNA or RNA. This test is crucial for individuals who may be at risk for chronic HBV infection, as such infections significantly increase the likelihood of developing serious liver conditions, including cirrhosis and hepatocellular carcinoma. Hepatitis B virus can be transmitted through various means, including blood and body fluids, sexual contact, from mother to infant during childbirth, and through shared contaminated objects like needles, razors, and toothbrushes. The ability to detect HBV nucleic acid is particularly valuable in cases where hepatitis B surface Antigen (HBsAg) tests return negative results, providing essential prognostic information. To perform this test, a blood sample is collected, and the serum or plasma is analyzed. The methodology employed for this detection often involves real-time polymerase chain reaction (RT-PCR), a sophisticated technique that amplifies specific strands of HBV DNA or RNA. During this process, the targeted nucleic acid sequences are replicated and subsequently identified using DNA probes that are tagged with fluorescent or chemiluminescent markers, ensuring specificity to the target sequence. This advanced detection method allows for the identification of HBV DNA or RNA even at very low viral loads, as minimal as 20 IU/mL (116 copies/mL). The presence of these nucleic acids in the amplified sample can indicate ongoing low-level viral replication, suggesting an active HBV infection. CPT® Code 87517 is specifically utilized for the quantification of HBV DNA or RNA, providing a measurement of the viral load present in the sample. This quantitative assessment is critical for monitoring the progression of the disease and evaluating the effectiveness of treatment regimens. The use of quantitative or real-time PCR techniques allows for the generation of detailed reports that document the absolute or relative amounts of the detected nucleic acid sequences, thereby facilitating informed clinical decision-making regarding patient management.
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The CPT® Code 87517 is indicated for the detection and quantification of the hepatitis B virus (HBV) in patients who may be at risk for chronic HBV infection. The following conditions and scenarios warrant the use of this test:
The procedure for CPT® Code 87517 involves several key steps to ensure accurate detection and quantification of HBV nucleic acid. The following outlines the procedural steps:
After the completion of the procedure associated with CPT® Code 87517, the patient may not require any specific post-procedure care, as the test is minimally invasive. However, it is essential for healthcare providers to communicate the results to the patient promptly. The quantification of HBV DNA or RNA will inform the clinician about the viral load, which is critical for monitoring disease progression and evaluating the response to treatment. Patients may need to follow up for further testing or treatment adjustments based on the results obtained from this test. Additionally, healthcare providers should ensure that patients understand the implications of their test results and any necessary next steps in their care plan.
| Short Descr | HEPATITIS B DNA QUANT | Medium Descr | IADNA HEPATITIS B VIRUS QUANTIFICATION | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, quantification | 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. | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine 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 | 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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| 2011-01-01 | Changed | Short description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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