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The CPT® Code 87521 refers to the detection of the hepatitis C virus (HCV) through nucleic acid testing, specifically utilizing an amplified probe technique. This procedure is crucial for identifying the presence of HCV, which is known to cause inflammation of the liver and can lead to serious complications such as chronic hepatitis C, cirrhosis, and liver cancer. The detection process involves analyzing the nucleic acids—either DNA or RNA—of the virus to determine if a patient has an active or chronic infection. The amplified probe technique enhances the sensitivity of the test, allowing for the detection of even low levels of the virus that may not be identifiable through standard methods. This is achieved through a process that includes reverse transcription, where the viral RNA is converted into complementary DNA (cDNA) for amplification. The use of specific primers and polymerase enzymes enables the replication of target sequences, resulting in a measurable fluorescent signal that indicates the presence of the virus. This method not only confirms infection but also aids in assessing the severity of the disease and monitoring the effectiveness of treatment.
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The procedure associated with CPT® Code 87521 is indicated for the detection of the hepatitis C virus (HCV) in patients who may be experiencing symptoms or conditions related to HCV infection. The following are specific indications for performing this nucleic acid detection test:
The procedure for CPT® Code 87521 involves several critical steps to ensure accurate detection of the hepatitis C virus. Each step is essential for the successful identification of the viral nucleic acids:
After the completion of the nucleic acid detection procedure, the results are analyzed and interpreted by laboratory professionals. The findings will indicate whether the hepatitis C virus is present in the sample and, if so, the level of viral load. This information is critical for determining the appropriate clinical management and treatment options for the patient. Additionally, healthcare providers may discuss the results with the patient, including implications for treatment and follow-up care. It is important to ensure that patients understand the significance of the results and any necessary next steps in their healthcare journey.
| Short Descr | HEPATITIS C PROBE&RVRS TRNSC | Medium Descr | IADNA HEPATITIS C AMPLIFIED PROBE&REVRSE TRANSCR | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse transcription when performed | 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) |
| 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. | 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. | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | 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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| 2014-01-01 | Changed | Description Changed |
| 2013-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Short description changed. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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