Clinical Context
A 42-year-old patient with chronic hepatitis B infection presents for evaluation of worsening liver enzymes and new onset fatigue. The clinician orders a quantitative hepatitis D viral load to determine active hepatitis D virus (HDV) replication because HDV only occurs with hepatitis B virus (HBV) co-infection and can accelerate liver injury. A phlebotomy technician collects a blood specimen in an appropriate viral transport tube; the specimen is sent to a molecular diagnostics laboratory. In the lab, a nucleic acid amplification test using a DNA/RNA probe quantifies HDV RNA and reports viral load in international units per milliliter. Results are provided to the ordering provider and placed in the medical record to guide disease staging and antiviral or referral decisions.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|
87523 | Using a nucleic acid (DNA or RNA) probe technique, the test quantifies the level of hepatitis D (delta) viral particles in the patient specimen, called viral load. | Primary procedure: quantifies HDV RNA to assess active infection in patients with hepatitis B co-infection. |
87622 | Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C virus, amplified probe technique. | Related molecular viral load testing for hepatitis C performed in similar molecular workflows when evaluating viral hepatitis etiologies.
87340 | Hepatitis B virus surface antigen (HBsAg) test. | Often performed alongside HDV testing to confirm current hepatitis B infection required for HDV presence.
87491 | Infectious agent antigen detection by immunoassay technique; hepatitis C, acute. | Immunoassay tests for hepatitis viruses may be ordered in the diagnostic evaluation panel with molecular tests.
86704 | Hepatitis B core antibody (anti-HBc) serologic test. | Serologic markers for HBV (core antibody) are commonly used in initial evaluation and to interpret HDV results.
86403 | Hepatitis D virus antibody, total (HDV Ab). | Serologic screening for HDV antibody can precede or accompany nucleic acid testing to establish exposure and guide RNA testing.
80061 | Lipid panel (cholesterol, HDL, triglycerides) — example metabolic test. | Not directly related to HDV testing but commonly ordered in liver disease management for baseline metabolic risk assessment.
82270 | Bilirubin, total. | Liver function tests such as bilirubin are commonly ordered concurrently to assess hepatic injury in patients with viral hepatitis.
84460 | Thyroid stimulating hormone (TSH). | Routine labs sometimes included in comprehensive evaluations but not specific to HDV testing.
80053 | Comprehensive metabolic panel. | Standard panel to evaluate hepatic and renal function when assessing patients with chronic viral hepatitis.