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Official Description

Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including reverse transcription, when performed

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 87523 refers to a laboratory test designed for the detection and quantification of the hepatitis D (delta) virus, utilizing nucleic acid techniques. This procedure specifically targets the presence of the hepatitis D virus (HDV) in serum or plasma samples through a method known as real-time polymerase chain reaction (RT-PCR). Hepatitis D is a unique viral infection that can only occur in individuals who are also infected with the hepatitis B virus (HBV), as it relies on HBV for its replication. The hepatitis D virus is classified as a mutated RNA virus and is distinct from other hepatitis viruses such as A, B, and C. The presence of HDV can lead to severe liver complications, particularly in patients with existing hepatitis B infections, potentially resulting in conditions such as fulminant acute hepatitis, cirrhosis, and hepatocellular carcinoma. The testing process involves treating the viral RNA to protect it from degradation, followed by reverse transcription, which converts the RNA into complementary DNA (cDNA). This cDNA is then amplified using specific primers that bind to the target nucleic acid, allowing for the measurement of fluorescence at each cycle of the PCR process. The quantification of the generated DNA is crucial for monitoring the progression of the disease and assessing the patient's response to treatment.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The CPT® Code 87523 is indicated for the detection and quantification of the hepatitis D (delta) virus in patients who are known to be infected with the hepatitis B virus. The following conditions may warrant the use of this test:

  • Hepatitis B Co-infection Patients who are co-infected with hepatitis B and require monitoring for the presence of hepatitis D virus.
  • Severe Liver Disease Individuals exhibiting symptoms of severe liver disease, including acute or chronic hepatitis B, where the presence of HDV may exacerbate the condition.
  • Monitoring Treatment Response Patients undergoing treatment for hepatitis B who need to assess the impact of therapy on hepatitis D virus levels.
  • Assessment of Disease Progression Individuals with known hepatitis B infection who require evaluation of disease progression and potential complications associated with hepatitis D.

2. Procedure

The procedure for CPT® Code 87523 involves several critical steps to ensure accurate detection and quantification of the hepatitis D virus. The following outlines the procedural steps:

  • Sample Collection A sample of serum or plasma is collected from the patient, which serves as the biological material for testing. Proper collection techniques are essential to avoid contamination and ensure the integrity of the sample.
  • RNA Treatment The viral RNA extracted from the sample is treated to protect it from degradation. This step is crucial as the RNA is fragile and can be easily broken down by environmental factors.
  • Reverse Transcription The treated RNA undergoes reverse transcription, a process that converts the RNA into complementary DNA (cDNA). This conversion is necessary because the subsequent amplification process requires DNA as the template.
  • Amplification Specific primers are added to the cDNA. These primers are short, artificial strands of nucleic acid that are complementary to the target sequence of the hepatitis D virus. The polymerase enzyme is then introduced to copy the target region, resulting in the amplification of the cDNA.
  • Fluorescence Measurement As the amplification process occurs, the newly synthesized DNA fluoresces. The fluorescence is measured at the end of each PCR cycle, allowing for the quantification of the amount of DNA generated, which correlates with the viral load of hepatitis D in the sample.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 87523, the laboratory will analyze the results and provide a report detailing the presence and quantity of the hepatitis D virus. Clinicians will use this information to monitor disease progression, evaluate the effectiveness of treatment, and make informed decisions regarding patient management. It is important for healthcare providers to interpret the results in the context of the patient's overall clinical picture, including any co-infections and liver function status. Follow-up testing may be necessary based on the initial findings to ensure ongoing monitoring of the patient's condition.

Short Descr HEPATITIS D QUANTIFICATION
Medium Descr IADNA HEPATITIS D DELTA QUAN W/REV TRANSCRIPTION
Long Descr Infectious agent detection by nucleic acid (DNA or RNA); hepatitis D (delta), quantification, including 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) No
APC Status Indicator Conditionally packaged laboratory tests
Type of Service (TOS) 5 - Diagnostic Laboratory
Berenson-Eggers TOS (BETOS) none
MUE 1
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.
Date
Action
Notes
2024-01-01 Added Code Added.
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Description
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