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The CPT® Code 87532 refers to a laboratory test designed for the detection of the infectious agent known as human herpes virus-6 (HHV-6) through the use of nucleic acid amplification techniques. HHV-6 is a virus that can cause significant health issues, particularly in children and immunocompromised individuals. There are two variants of this virus: HHV-6A, which is primarily associated with roseola infantum in children, and HHV-6B, which can lead to a mononucleosis-like illness in those with weakened immune systems. The primary infection in children may manifest with symptoms such as fever, rash, and seizures, while reactivation of the virus in adults or immunocompromised patients can result in more severe symptoms, including fever, lymphadenopathy, pneumonitis, hepatitis, and encephalitis. The test utilizes an amplified probe technique to enhance the sensitivity of the assay, allowing for the detection of HHV-6 DNA or RNA in blood or cerebrospinal fluid (CSF) samples. This method involves the use of a direct probe test, which identifies a unique nucleic acid sequence specific to the HHV-6 organism. The probe is labeled with either fluorescent or chemiluminescent markers, enabling the visualization of the target sequence if present. The sample undergoes treatment to release nucleic acids from the target organism, and the labeled probe binds specifically to the matching target sequence, forming a stable hybrid. In the amplified probe technique, the sensitivity of the assay is significantly increased by exponentially multiplying the target sequence of HHV-6 DNA or RNA into millions of copies. The most commonly employed amplification methods include polymerase chain reaction (PCR) and reverse transcriptase polymerase chain reaction (RT-PCR). Following amplification, the replicated sequences are identified using labeled DNA probes. Additionally, nucleic acid detection with quantification can be performed to assess the quantity of microorganisms present, often utilizing quantitative or real-time PCR to provide detailed reports on the absolute or relative amounts of the identified nucleic acid sequence.
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The CPT® Code 87532 is indicated for the detection of human herpes virus-6 (HHV-6) in patients who may present with various symptoms or conditions associated with this viral infection. The following indications are explicitly recognized for this procedure:
The procedure for CPT® Code 87532 involves several critical steps to ensure accurate detection of HHV-6. Each step is designed to maximize the sensitivity and specificity of the test:
After the completion of the procedure associated with CPT® Code 87532, the laboratory will analyze the results and generate a report detailing the presence or absence of HHV-6 in the sample. If quantification was performed, the report will also include information regarding the viral load. Clinicians will use these results to guide further patient management and treatment decisions. It is important for healthcare providers to interpret the results in the context of the patient's clinical presentation and history. Follow-up care may be necessary based on the findings, especially in cases of reactivated infection in immunocompromised patients.
| Short Descr | HHV-6 DNA AMP PROBE | Medium Descr | IADNA HERPES VIRUS-6 AMPLIFIED PROBE TQ | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, amplified 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 | 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. | GZ | Item or service expected to be denied as not reasonable and necessary | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 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. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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 | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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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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