Summary & Overview
CPT 87389: HIV-1 Antigen and HIV-1/HIV-2 Antibody Detection by Immunoassay
CPT code 87389 represents a laboratory procedure for the detection of HIV-1 antigens and HIV-1 and HIV-2 antibodies using advanced immunoassay techniques. This code is central to HIV screening and diagnosis, supporting public health efforts to identify and manage HIV infections. The procedure is commonly performed in office-based settings and is recognized by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
This publication provides a comprehensive overview of 87389, including payer coverage, clinical context, and related billing codes. Readers will gain insight into current policy updates, reimbursement benchmarks, and the role of this code in infectious disease screening. The analysis also highlights common modifiers and associated taxonomies relevant to laboratory and physician billing. By understanding the scope and application of 87389, stakeholders can better navigate the evolving landscape of HIV testing and laboratory services.
CPT Code Overview
CPT code 87389 is used for the detection of infectious agent antigens by immunoassay techniques, specifically targeting HIV-1 antigens along with HIV-1 and HIV-2 antibodies, resulting in a single qualitative or semiquantitative outcome. This procedure utilizes methods such as enzyme immunoassay (EIA), enzyme-linked immunosorbent assay (ELISA), fluorescence immunoassay (FIA), or immunochemiluminometric assay (IMCA) in a multiple-step process. The service falls under Pathology and Laboratory Procedures – Microbiology Procedures – Infectious Agent Antigen Detection and is typically performed in an office setting (POS 11).
Clinical & Coding Specifications
Clinical Context
A patient presents to a primary care office for routine screening for human immunodeficiency virus (HIV). The provider orders a laboratory test to detect HIV-1 antigen(s) and HIV-1 and HIV-2 antibodies using a multiple-step immunoassay method. The specimen is collected in the office and sent to a clinical medical laboratory for analysis. The result provides a single qualitative or semiquantitative outcome for HIV-1 antigen(s) and HIV-1/HIV-2 antibodies. This workflow is typical for preventive screening or diagnostic evaluation of HIV status in adults and adolescents.
Coding Specifications
- Modifier
92: Used when the test is performed using a disposable or transportable, single-use kit (point-of-service testing), such as in-office rapid testing platforms.
| Modifier Code | Description |
|---|---|
92 | Alternative laboratory platform testing when the test is performed using a disposable or transportable, single-use kit (point-of-service testing) |
- Associated Provider Taxonomies: