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The CPT® Code 87624 refers to the detection of infectious agents through nucleic acid testing, specifically targeting high-risk types of Human Papillomavirus (HPV). HPV is a virus that can invade the skin and mucosal epithelia, leading to both clinical and subclinical infections. There are over 100 known types of HPV, with approximately 40 types affecting the anogenital region. Among these, certain high-risk oncogenic types, such as HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68, are often associated with high-grade squamous intraepithelial lesions (HSIL) and invasive cancers. In contrast, low-risk HPV types are linked to conditions such as acuminate condylomas and low-grade squamous intraepithelial lesions (LSIL) of the cervix. The detection of HPV through nucleic acid testing has become a standard practice in managing cervical disease in women. The procedure involves collecting exfoliated cervical cells using tools like a cytobrush or swab, which are then placed in a liquid transport medium. The sample undergoes treatment with sodium hydroxide to denature the DNA, followed by hybridization with specific RNA probes that identify both low-risk and high-risk HPV types. The resulting hybrids are analyzed using a luminometer to quantify the presence of high-risk HPV types, providing critical information for patient management and treatment decisions.
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The procedure associated with CPT® Code 87624 is indicated for the detection of high-risk types of Human Papillomavirus (HPV) in patients who may be at risk for cervical disease. The following conditions and situations warrant the use of this testing:
The procedure for CPT® Code 87624 involves several critical steps to ensure accurate detection of high-risk HPV types. The process begins with the collection of exfoliated cervical cells from the patient. This is typically done using a cytobrush, swab, or plastic spatula, which allows for the effective gathering of cells from the cervix. Once collected, these cells are re-suspended in a liquid transport medium to preserve their integrity during transport to the laboratory.
Next, the cell sample undergoes treatment with sodium hydroxide. This step is crucial as it denatures the DNA, making it easier for the subsequent hybridization process to occur. Following denaturation, the sample is hybridized in a solution containing two mixtures of non-isotope single-stranded RNA probes. One of these probes is designed to detect five low-risk HPV types, while the other targets thirteen high-risk HPV types.
After hybridization, the resulting products are transferred to a microplate that contains antibody-coated wells specifically designed to recognize the HPV DNA/RNA hybrids. An alkaline phosphatase-labeled monoclonal antibody is then added to the wells, which binds to the hybrids. Following this, a chemiluminescent substrate is introduced, and the light produced from this reaction is measured using a luminometer. The luminometer quantifies the light output, providing a ratio of reactivity that indicates the presence of high-risk HPV types in the sample.
After the completion of the HPV testing procedure, the results are typically analyzed and reported back to the healthcare provider. The expected recovery for patients is generally straightforward, as the procedure involves non-invasive sampling. Patients may experience minimal discomfort during the collection of cervical cells, but there are no significant post-procedure care requirements. It is essential for healthcare providers to discuss the results with patients, including the implications of positive or negative findings for high-risk HPV types. Follow-up care may be necessary based on the results, particularly if high-risk HPV types are detected, as this may influence further diagnostic or therapeutic interventions.
| Short Descr | HPV HI-RISK TYP POOLED RSLT | Medium Descr | IADNA HUMAN PAPILLOMAVIRUS HI-RSK TYP POOLD RSLT | Long Descr | Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result | 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 |
| 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 | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GZ | Item or service expected to be denied as not reasonable and necessary | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 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. | Q4 | Service for ordering/referring physician qualifies as a service exemption | 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. | 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. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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 | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | QW | Clia waived test | RT | Right side (used to identify procedures performed on the right side of the body) | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2025-01-01 | Changed | Short, Medium, and Long Descriptions changed. |
| 2015-01-01 | Added | Added |
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