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The CPT® Code 87533 refers to a laboratory test designed for the detection of the infectious agent known as human herpes virus-6 (HHV-6) through the analysis of nucleic acids, specifically DNA or RNA. HHV-6 is a virus that can lead to various 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 cause a mononucleosis-like illness in those with weakened immune systems. The primary infection in children may manifest through symptoms such as fever, rash, and seizures, while reactivation of the virus can lead to more severe symptoms, including fever, lymphadenopathy (swollen lymph nodes), pneumonitis (lung inflammation), hepatitis (liver inflammation), and encephalitis (brain inflammation). The test utilizes a direct probe method to identify the unique nucleic acid sequence of the HHV-6 organism, if present in blood or cerebrospinal fluid (CSF) samples. This method involves the use of a probe that is labeled with either fluorescent or chemiluminescent markers. The sample undergoes treatment to release nucleic acids from the target organism, allowing the labeled probe to specifically bind to the matching target sequence, forming a stable hybrid. Ribosomal RNA is often the focus of this detection process due to its abundance in microorganisms, as it is typically present in thousands of copies compared to the limited copies found in genomic DNA. To enhance the sensitivity of the assay, an amplified probe technique may be employed, which significantly increases the number of target sequences of HHV-6 DNA or RNA through exponential amplification, resulting in millions of copies. The polymerase chain reaction (PCR) or reverse transcriptase polymerase chain reaction (RT-PCR) are the most commonly used amplification techniques. Following amplification, the replicated sequences are identified using labeled DNA probes. The quantification aspect of this test, as indicated by CPT® Code 87533, provides an assessment of the quantity of microorganisms present by utilizing quantitative or real-time PCR. This method allows for the amplification of the isolated nucleic acid segment and generates reports at each stage to document the absolute or relative amounts of the known nucleic acid sequence, thereby offering valuable information regarding the viral load in the sample.
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Detection of HHV-6 Infection The test is indicated for the detection of human herpes virus-6 (HHV-6) in patients who present with symptoms consistent with primary infection or reactivation of the virus. Symptoms may include fever, rash, and seizures in children, or fever, lymphadenopathy, pneumonitis, hepatitis, and encephalitis in immunocompromised individuals.
Step 1: Sample Collection The procedure begins with the collection of a biological sample, which may be blood or cerebrospinal fluid (CSF). Proper collection techniques must be followed to ensure the integrity of the sample for accurate testing.
Step 2: Nucleic Acid Release Once the sample is collected, it is treated to release nucleic acids from the HHV-6 organism, if present. This step is crucial as it prepares the sample for the subsequent detection process.
Step 3: Probe Hybridization A direct probe test is then conducted, where a labeled probe, either fluorescent or chemiluminescent, is introduced to the sample. This probe is designed to specifically bind to the unique nucleic acid sequence of the HHV-6 organism, forming a stable hybrid if the target sequence is present.
Step 4: Amplification of Target Sequences To enhance the sensitivity of the test, an amplified probe technique may be utilized. This involves exponentially multiplying the target sequence of HHV-6 DNA or RNA into millions of copies. The most commonly used amplification methods are polymerase chain reaction (PCR) or reverse transcriptase polymerase chain reaction (RT-PCR).
Step 5: Detection of Amplified Sequences After amplification, the replicated nucleic acid sequences are identified using labeled DNA probes. This step is essential for confirming the presence of HHV-6 in the sample.
Step 6: Quantification Finally, the nucleic acid detection with quantification is performed, which assesses the number of microorganisms present in the sample. Quantitative or real-time PCR is often employed to amplify the nucleic acid segment and generate a report documenting the absolute or relative amounts of the known nucleic acid sequence.
Post-procedure care typically involves the proper handling and storage of the biological sample to ensure the accuracy of results. Patients may be monitored for any adverse reactions related to the sample collection process. The results of the HHV-6 detection test will be analyzed and reported, providing critical information regarding the presence and quantity of the virus, which can guide further clinical management and treatment decisions.
| Short Descr | HHV-6 DNA QUANT | Medium Descr | IADNA HERPES VIRUS-6 QUANTIFICATION | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, 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. | 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. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m 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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