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Ray Sukumar, MD

Venkataraman Posted Sun 04th of January, 2015 16:31:10 PM

We do PCR to look for HRHPV & if positive we look for specific types of HRHPV like 16 & 18; should we use 87624 for the first & then 87625 for the latter?

SuperCoder Answered Mon 05th of January, 2015 07:13:57 AM

Thank you for your question.

87624 should be used for the first test and 87625 should be used for the latter testing, you are correct. See below:

Clinical Responsibility

The lab analyst performs the technical steps to detect human papillomavirus through nucleic acid detection. Nucleic acid probes permit identification of microorganisms based on their DNA or RNA. Nucleic acid quantitation allows assessment of treatment response. Quantitation refers to measuring the exact amount of a substance.

Although not limited to testing for specific conditions, the lab analyst performs this procedure for detection of high risk types of human papillomavirus, for example, types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68.

For the same services involving low risk types HPV, use 87623, Infectious agent detection by nucleic acid DNA or RNA; human papillomavirus, or HPV, low risk types, for example, types 6, 11, 42, 43, and 44.

For the same services involving types 16 and 18 only, and 45, if performed, use 87625, Infectious agent detection by nucleic acid DNA or RNA; human papillomavirus, or HPV, types 16 and 18 only; includes type 45, if performed.

Venkataraman Posted Tue 06th of January, 2015 15:30:18 PM

Thank you for your response above. Please allow me to be a little more specific in my wording.

Our lab does Identification for a multitude of HPV high risk and low risk types (including all types listed in the above examples); meaning we test for more than just HPV high risk types 16, 18 and 45.

With that said, should we be using 87624 for Detection as well as Identification? If so, please confirm that we would bill 87624 x2 units (1x unit for Detection and 1x unit for Identification).

Are the CPT codes independent of final results?

SuperCoder Answered Tue 06th of January, 2015 17:08:01 PM

Yes, you are correct. 87624 x2 is the appropriate billing for the scenario described above. This will cover the detection and identification.

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