Summary & Overview
CPT 87517: Hepatitis B Virus Quantitative Nucleic Acid Probe Test
CPT code 87517 represents a molecular diagnostic assay that quantifies hepatitis B virus (HBV) using a nucleic acid probe technique. This test is clinically important for identifying and monitoring active HBV infection, informing clinical management of acute and chronic liver disease, and guiding public health surveillance. Nationally, HBV testing supports prevention of transmission and appropriate linkage to care.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what CPT code 87517 covers, the clinical context for its use, and the typical laboratory setting where the service is performed. The publication also summarizes common billing considerations, relevant modifiers (listed separately), and what to expect in payer coverage patterns.
This summary provides benchmarks and policy-relevant points for stakeholders interested in laboratory reimbursement, coding compliance, and service utilization for HBV molecular testing. Data not available in the input is noted where applicable, and the focus remains on the clinical and billing definition of CPT code 87517 for a national audience.
Billing Code Overview
CPT code 87517 describes a laboratory test that quantifies infection with hepatitis B virus (HBV) using a nucleic acid probe technique. The procedure is used to detect and measure viral nucleic acid to assess active HBV infection, which can present as acute or chronic liver disease.
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Service type: Molecular diagnostic test (nucleic acid probe assay)
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Typical site of service: Clinical laboratory or hospital laboratory setting where molecular virology testing is performed.
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient with known chronic hepatitis B infection presents for routine viral load monitoring to assess response to antiviral therapy. The clinician orders a quantitative hepatitis B virus (HBV) nucleic acid test to measure circulating HBV DNA. Blood is drawn in an outpatient phlebotomy area; the specimen is transported to the molecular diagnostics laboratory. A medical laboratory technologist or molecular lab analyst performs the 87517 assay using a nucleic acid probe technique (or equivalent nucleic acid amplification/quantitation platform), reports a numeric HBV DNA result (IU/mL or copies/mL) with interpretive comments, and the result is made available in the electronic medical record for the ordering provider to review. Typical sites of service include outpatient clinics, ambulatory surgery centers with laboratory services, community hospitals, and reference laboratories. Typical clinical indications include staging of chronic HBV infection, assessing antiviral therapy efficacy, evaluation of acute HBV infection when needed for viral quantification, and guiding management decisions such as therapy initiation or modification.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician or laboratory professional interpretation component separate from the technical testing (rare for most molecular assays). |