CPT 87516: Hepatitis B Virus, Amplified Nucleic Acid Probe Test

CPT code 87516 describes a laboratory test that detects hepatitis B virus (HBV) using an amplified nucleic acid probe technique; this is a molecular diagnostic service performed by a lab analyst to identify HBV RNA/DNA for evaluation of acute or chronic liver infection, typically classified as a molecular diagnostic test and provided in a clinical laboratory or hospital laboratory setting.

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CPT 87516: Hepatitis B Virus, Amplified Nucleic Acid Probe Test

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Clinical & Coding Specifications

Clinical Context

A 34-year-old patient presents to an outpatient infectious disease clinic after a needlestick exposure at work. The clinician orders a sensitive laboratory assay to detect hepatitis B virus (HBV) nucleic acid to evaluate possible acute infection and to guide post-exposure management. The specimen is collected (typically a venous blood draw) and sent to a molecular diagnostics laboratory. A molecular technologist performs an amplified nucleic acid probe technique to detect HBV DNA, documents results in the laboratory information system, and the ordering clinician reviews the result to determine need for antiviral therapy, immunoprophylaxis, or further follow-up.

Service Type: Molecular diagnostic laboratory test using amplified nucleic acid probe technique for hepatitis B virus.

Typical Site of Service: Hospital outpatient laboratory, independent reference laboratory, or hospital inpatient laboratory performing molecular virology testing.

Typical Patient Scenario: Testing is commonly ordered for symptomatic patients with acute hepatitis signs (jaundice, elevated liver enzymes), occupational exposures, evaluation of suspected perinatal transmission, or monitoring possible breakthrough infection in patients with immunosuppression.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87622`	Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, single reportable analyte	Performed for concurrent evaluation of blood-borne viral exposures when assessing need for comprehensive post-exposure testing.
`87536`	Infectious agent detection by nucleic acid (DNA or RNA); Hepatitis C virus, amplified probe technique	Often ordered alongside HBV nucleic acid testing for complete hepatitis evaluation.
`80053`	Comprehensive metabolic panel (CMP)	Provides liver function tests (ALT/AST, bilirubin) used concurrently to assess hepatic injury when HBV infection is suspected.
`86704`	Hepatitis B surface antigen (HBsAg)	Serologic test frequently ordered before or alongside HBV nucleic acid testing to determine active infection status.
`86706`	Hepatitis B core antibody (anti-HBc) total	Serologic marker used to determine prior exposure or acute infection phase in conjunction with molecular testing.

Related Modifiers

6 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
91	Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…	- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
90	Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…	- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
174400000X	Specialist	An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond…
202C00000X	Independent Medical Examiner Physician	A special evaluator not involved with the medical care of the individual examinee that impartially evaluates the care being provided by other practiti…
225XE0001X	Environmental Modification Occupational Therapist	Occupational therapy practitioners are experts at identifying the cause of difficulties in performance of activities of daily living and instrumental …
3336S0011X	Specialty Pharmacy	A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses t…

Related Payer Policy Updates

Specialty: Infectious Disease1 / 3

10 rows

Policy	Payer	Effective Date
B-Hemolytic Streptococcus Testing	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays	Oscar Health	2026-10-01
Hepatitis Testing (A, B, C, D) Coverage Criteria	Oscar Health	2026-10-01
Pathogen Panel Testing	Oscar Health	2026-10-01
Lyme Disease Testing Coverage Criteria	Oscar Health	2026-10-01
Diagnostic Testing of Common Sexually Transmitted Infections	Oscar Health	2026-10-01
Testing for Diagnosis of Active or Latent Tuberculosis	Oscar Health	2026-10-01
Coronavirus Testing in the Outpatient Setting	Oscar Health	2026-10-01
Testing for Vector-Borne Infections	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV)	blue cross blue shield - louisiana	2026-09-15

CPT 87260: Adenovirus Antigen Detection by Immunofluorescence

CPT-87265-BORDETELLA-IMMUNOFLUORESCENT-ANTIGEN-DETECTION

CPT 87265: Bordetella Antigen Detection by Immunofluorescence

CPT-87267-ENTEROVIRUS-DFA-ANTIGEN-DETECTION

CPT 87267: Enterovirus Antigen Detection by DFA

CPT-87269-GIARDIA-IMMUNOFLUORESCENT-ANTIGEN-DETECTION

CPT 87269: Giardia Antigen Detection by Immunofluorescence

CPT-87270-CHLAMYDIA-TRACHOMATIS-IMMUNOFLUORESCENT-ANTIGEN-DETECTION

CPT 87270: Chlamydia trachomatis Antigen Detection by Immunofluorescence

CPT-87271-CMV-DFA-ANTIGEN-DETECTION

CPT 87271: CMV Antigen Detection by Direct Fluorescent Antibody

CPT-87272-CRYPTOSPORIDIUM-IMMUNOFLUORESCENT-ANTIGEN-DETECTION

CPT 87272: Cryptosporidium Antigen Immunofluorescent Test

CPT-87273-HSV-2-ANTIGEN-IMMUNOFLUORESCENCE

CPT 87273: HSV-2 Antigen Detection by Immunofluorescence

CPT-87274-HSV-1-ANTIGEN-IMMUNOFLUORESCENCE

CPT 87274: HSV-1 Antigen Detection by Immunofluorescence

CPT-87275-INFLUENZA-B-IMMUNOFLUORESCENT-ANTIGEN-DETECTION

CPT 87275: Influenza B Antigen Detection by Immunofluorescence

Showing 1–10 of 167

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Service Type: Molecular diagnostic laboratory test using amplified nucleic acid probe technique for hepatitis B virus.

Typical Site of Service: Hospital outpatient laboratory, independent reference laboratory, or hospital inpatient laboratory performing molecular virology testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87622`	Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, single reportable analyte	Performed for concurrent evaluation of blood-borne viral exposures when assessing need for comprehensive post-exposure testing.
`87536`	Infectious agent detection by nucleic acid (DNA or RNA); Hepatitis C virus, amplified probe technique	Often ordered alongside HBV nucleic acid testing for complete hepatitis evaluation.
`80053`	Comprehensive metabolic panel (CMP)	Provides liver function tests (ALT/AST, bilirubin) used concurrently to assess hepatic injury when HBV infection is suspected.
`86704`	Hepatitis B surface antigen (HBsAg)	Serologic test frequently ordered before or alongside HBV nucleic acid testing to determine active infection status.
`86706`	Hepatitis B core antibody (anti-HBc) total	Serologic marker used to determine prior exposure or acute infection phase in conjunction with molecular testing.

Related Modifiers

6 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
91	Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…	- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
90	Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…	- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
174400000X	Specialist	An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond…
202C00000X	Independent Medical Examiner Physician	A special evaluator not involved with the medical care of the individual examinee that impartially evaluates the care being provided by other practiti…
225XE0001X	Environmental Modification Occupational Therapist	Occupational therapy practitioners are experts at identifying the cause of difficulties in performance of activities of daily living and instrumental …
3336S0011X	Specialty Pharmacy	A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses t…

Related Payer Policy Updates

Specialty: Infectious Disease1 / 3

10 rows

Policy	Payer	Effective Date
B-Hemolytic Streptococcus Testing	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays	Oscar Health	2026-10-01
Hepatitis Testing (A, B, C, D) Coverage Criteria	Oscar Health	2026-10-01
Pathogen Panel Testing	Oscar Health	2026-10-01
Lyme Disease Testing Coverage Criteria	Oscar Health	2026-10-01
Diagnostic Testing of Common Sexually Transmitted Infections	Oscar Health	2026-10-01
Testing for Diagnosis of Active or Latent Tuberculosis	Oscar Health	2026-10-01
Coronavirus Testing in the Outpatient Setting	Oscar Health	2026-10-01
Testing for Vector-Borne Infections	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV)	blue cross blue shield - louisiana	2026-09-15

CPT 87260: Adenovirus Antigen Detection by Immunofluorescence

CPT-87265-BORDETELLA-IMMUNOFLUORESCENT-ANTIGEN-DETECTION

CPT 87265: Bordetella Antigen Detection by Immunofluorescence

CPT-87267-ENTEROVIRUS-DFA-ANTIGEN-DETECTION

CPT 87267: Enterovirus Antigen Detection by DFA

CPT-87269-GIARDIA-IMMUNOFLUORESCENT-ANTIGEN-DETECTION

CPT 87269: Giardia Antigen Detection by Immunofluorescence

CPT-87270-CHLAMYDIA-TRACHOMATIS-IMMUNOFLUORESCENT-ANTIGEN-DETECTION

CPT 87270: Chlamydia trachomatis Antigen Detection by Immunofluorescence

CPT-87271-CMV-DFA-ANTIGEN-DETECTION

CPT 87271: CMV Antigen Detection by Direct Fluorescent Antibody

CPT-87272-CRYPTOSPORIDIUM-IMMUNOFLUORESCENT-ANTIGEN-DETECTION

CPT 87272: Cryptosporidium Antigen Immunofluorescent Test

CPT-87273-HSV-2-ANTIGEN-IMMUNOFLUORESCENCE

CPT 87273: HSV-2 Antigen Detection by Immunofluorescence

CPT-87274-HSV-1-ANTIGEN-IMMUNOFLUORESCENCE

CPT 87274: HSV-1 Antigen Detection by Immunofluorescence

CPT-87275-INFLUENZA-B-IMMUNOFLUORESCENT-ANTIGEN-DETECTION

CPT 87275: Influenza B Antigen Detection by Immunofluorescence

Showing 1–10 of 167

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 87516: Hepatitis B Virus, Amplified Nucleic Acid Probe Test

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OpenPayer

CPT 87516: Hepatitis B Virus, Amplified Nucleic Acid Probe Test

Sign up for cpt 87516 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

CPT 87516: Hepatitis B Virus, Amplified Nucleic Acid Probe Test

Sign up for cpt 87516 policy alerts

CPT 87516: Hepatitis B Virus, Amplified Nucleic Acid Probe Test

Sign up for cpt 87516 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What clinical situations commonly prompt use of CPT 87516?

Where is the CPT 87516 service typically performed?

Which related tests are frequently ordered alongside CPT 87516?

What diagnoses listed in the content are relevant when submitting CPT 87516?

What does the procedure described by CPT 87516 involve in the laboratory?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What clinical situations commonly prompt use of CPT 87516?

Where is the CPT 87516 service typically performed?

Which related tests are frequently ordered alongside CPT 87516?

What diagnoses listed in the content are relevant when submitting CPT 87516?

What does the procedure described by CPT 87516 involve in the laboratory?

References