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Official Description

Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 87520 refers to the detection of the hepatitis C virus (HCV) through nucleic acid testing, specifically utilizing a direct probe technique. Hepatitis C is a viral infection that primarily affects the liver, leading to inflammation and potentially resulting in chronic conditions such as cirrhosis and liver cancer. The detection of HCV's nucleic acid, either DNA or RNA, is crucial for determining the presence of an ongoing or chronic infection in patients. This method is particularly effective in identifying low levels of the virus, which may not be detectable through other means. The direct probe technique involves the use of laboratory-prepared complementary strands of nucleic acid that are designed to bind specifically to the target nucleic acid of the virus. These probes are often labeled with chemical fluorescence, allowing for the formation of stable, double-stranded complexes that can be identified within the sample. This process is essential for accurate diagnosis and management of hepatitis C, as it provides vital information regarding the presence of the virus in the patient's system.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 87520 is indicated for the detection of the hepatitis C virus (HCV) in patients who may be experiencing symptoms or conditions related to hepatitis C infection. The following are specific indications for performing this nucleic acid detection:

  • Chronic Hepatitis C Infection Patients suspected of having a chronic infection due to ongoing symptoms or previous positive serological tests.
  • Monitoring Treatment Response Individuals undergoing treatment for hepatitis C to evaluate the effectiveness of the therapy.
  • Assessment of Viral Load Patients requiring quantification of the viral load to assess the severity of the infection.

2. Procedure

The procedure for CPT® Code 87520 involves several critical steps to accurately detect the presence of the hepatitis C virus through nucleic acid testing. The following outlines the procedural steps:

  • Sample Collection A specimen is collected from the patient, typically blood, which contains the viral nucleic acid. This sample is essential for the subsequent testing process.
  • Nucleic Acid Extraction The nucleic acid is extracted from the collected sample. This step involves breaking down the cellular components to release the viral RNA or DNA, which is necessary for detection.
  • Hybridization with Direct Probe The extracted nucleic acid is then subjected to hybridization with a laboratory-prepared direct probe. This probe consists of complementary strands of nucleic acid that specifically bind to the target HCV nucleic acid, forming stable complexes.
  • Fluorescence Detection The binding of the probe to the target nucleic acid is detected through fluorescence. The presence of fluorescence indicates the successful formation of the double-stranded complexes, confirming the presence of HCV in the sample.

3. Post-Procedure

After the completion of the nucleic acid detection procedure, the results are analyzed and interpreted by laboratory professionals. The detection of HCV through this method provides critical information regarding the patient's infection status. If the test is positive, further evaluation may be necessary to determine the extent of the infection and appropriate treatment options. Additionally, the results can guide healthcare providers in monitoring the patient's response to treatment and making informed decisions regarding ongoing management of hepatitis C. It is essential for healthcare professionals to communicate the results to the patient and discuss any necessary follow-up actions.

Short Descr HEPATITIS C RNA DIR PROBE
Medium Descr IADNA HEPATITIS C DIRECT PROBE TECHNIQUE
Long Descr Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe technique
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.
GW Service not related to the hospice patient's terminal condition
Date
Action
Notes
2011-01-01 Changed Short description changed.
1998-01-01 Added First appearance in code book in 1998.
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