Summary & Overview
CPT 87380: Hepatitis D (Delta) Antigen Immunoassay
CPT code 87380 represents an immunoassay performed to detect antigens of hepatitis D (delta agent). This laboratory diagnostic code is used when a clinical laboratory conducts antigen testing for hepatitis D, commonly via enzyme immunoassay (EIA) techniques. The code matters nationally because hepatitis D is a serious viral co-infection that alters clinical management and public health reporting for patients with hepatitis B virus infection.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for antigen testing, typical sites of service (clinical and hospital laboratories), and the role of antigen assays in confirming hepatitis D infection. The publication also outlines common billing modifiers associated with laboratory services and highlights what to expect in payer coverage patterns and coding practice trends.
This summary equips laboratory managers, billing professionals, and policy analysts with a focused reference on CPT code 87380, clarifying the test purpose, care setting, and the payers commonly engaged in coverage and reimbursement. Data not available in the input will be noted where applicable in supporting sections.
Billing Code Overview
CPT code 87380 describes an immunoassay test to detect hepatitis D (delta agent) antigens, performed by a laboratory analyst. The service type is laboratory diagnostic testing (infectious disease serology). The typical site of service is a clinical laboratory or hospital laboratory where immunoassay-based serologic testing, such as enzyme immunoassay (EIA), is performed.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with known hepatitis B infection presenting for evaluation of possible hepatitis D (delta agent) coinfection due to worsening liver enzymes, new-onset jaundice, or exposure history (for example, injection drug use or household contact with a person with hepatitis D). The clinician orders a laboratory assay to detect hepatitis D antigen using an immunoassay technique (87380).
Workflow: The clinician documents symptoms, risk factors, and relevant laboratory abnormalities in the medical record and places an order for 87380. A phlebotomy technician collects a blood sample in the outpatient clinic, hospital laboratory, or reference lab. The specimen is processed by a laboratory technologist who performs the immunoassay (EIA) for hepatitis D antigen. Results are reported in the electronic health record to the ordering provider, who interprets results in the context of hepatitis B surface antigen status and liver function tests, and documents follow-up plans.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Denotes the office or outpatient visit component (professional service) | Use when reporting the physician's professional interpretation or oversight of the laboratory service when applicable (professional component reporting). Often paired with when splitting professional and technical components. |