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The CPT® Code 87538 refers to the detection of the infectious agent HIV-2 through nucleic acid techniques, specifically utilizing an amplified probe technique. This method includes reverse transcription when performed, which is essential for converting RNA into DNA, allowing for the identification of the HIV-2 virus. HIV-2 is one of the two serotypes of the human immunodeficiency virus, the other being HIV-1. The detection of HIV-2 is critical as it can lead to acquired immunodeficiency syndrome (AIDS), a severe condition that compromises the immune system by destroying CD4 T-cells, which are vital for immune response. The transmission of HIV-2 can occur through various means, including sexual contact, unscreened blood transfusions, sharing of needles, and from mother to child during pregnancy or breastfeeding. The procedure involves obtaining a blood sample from the patient, which is then processed to isolate the nucleic acids of the virus. Unlike direct probe techniques, which are less commonly used due to their requirement for culturing the specimen, the amplified probe technique allows for the detection of HIV-2 even when the viral load is low. This is achieved through amplification methods such as reverse transcription polymerase chain reaction (RT-PCR), which creates multiple copies of the viral nucleic acids, enhancing the likelihood of detection. The process includes lysing red blood cells to preserve leukocytes, followed by washing and pelleting the leukocytes to extract DNA. The final detection step confirms the presence of HIV-2 DNA in the specimen, providing crucial information for diagnosis and treatment monitoring.
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The CPT® Code 87538 is indicated for the detection of HIV-2 in patients who may be at risk for HIV infection or who exhibit symptoms consistent with HIV infection. The following conditions warrant the use of this procedure:
The procedure for CPT® Code 87538 involves several critical steps to ensure accurate detection of HIV-2 nucleic acids. The following procedural steps are performed:
Post-procedure care for patients undergoing testing with CPT® Code 87538 typically involves providing the patient with information regarding the testing process and what to expect regarding results. Patients may be advised to follow up with their healthcare provider to discuss the results and any necessary next steps, including potential treatment options if HIV-2 is detected. It is also important to monitor the patient for any signs of complications or adverse reactions related to the blood draw. Additionally, counseling may be offered to patients regarding safe practices to prevent the transmission of HIV.
| Short Descr | HIV-2 PROBE&REVRSE TRNSCRIPJ | Medium Descr | IADNA HIV-2 AMPLIFIED PROBE & REVERSE TRANSCRIPJ | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, 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) | 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. | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary |
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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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