Summary & Overview
CPT 87525: Hepatitis G (HGV/GBV) Direct Nucleic Acid Probe Test
CPT code 87525 represents a direct nucleic acid probe assay for detection of Hepatitis G virus (HGV/GBV). The test identifies viral genetic material and is used in diagnostic evaluation of suspected hepatitis or for epidemiologic and research purposes. As a molecular virology procedure performed in clinical laboratory settings, this code is relevant to hospital laboratories, independent reference labs, and public health laboratories across the country.
Key payers relevant to coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what CPT code 87525 covers, the clinical context for testing, and the typical laboratory setting where the service is performed. The publication also summarizes common billing modifiers and related administrative considerations when available, and presents benchmarking and policy updates when applicable.
This summary is intended for a national audience and provides an overview of the clinical purpose of the assay, the typical service environment, and the payer landscape addressed in the full publication. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 87525 describes a laboratory test that detects hepatitis G virus (HGV/GBV) using a direct nucleic acid probe technique. The service is a molecular diagnostic assay performed by a laboratory analyst to identify viral nucleic acid sequences consistent with hepatitis G infection.
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Service type: Molecular diagnostic virology test
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Typical site of service: Clinical laboratory or hospital laboratory setting
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient with elevated liver enzymes and a history of recent intravenous drug use presents to an outpatient infectious disease clinic for evaluation of viral hepatitis. The clinician orders a molecular diagnostic assay to detect Hepatitis G virus (HGV/GBV-C) RNA using a direct nucleic acid probe technique. Blood is collected in the laboratory phlebotomy area and routed to the molecular diagnostics laboratory. The lab analyst performs the 87525 test, which detects HGV RNA to determine active infection or carrier status. Results are reported to the ordering clinician and incorporated into the patient’s electronic medical record for treatment planning and public health reporting if appropriate.
Typical site of service: hospital-based outpatient laboratory, independent reference laboratory, or hospital molecular diagnostics laboratory.
Typical patient scenario: evaluation of unexplained transaminase elevation, screening in high-risk populations (e.g., persons who inject drugs, transfusion recipients), or epidemiologic surveillance where HGV RNA testing clarifies current infection status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component and the facility bills the technical component separately. |