Clinical Context
A 38-year-old patient with known HIV-1 infection presents to an infectious disease clinic with rising plasma viral load and suboptimal virologic response after a change in antiretroviral regimen. The clinician orders genotypic and phenotypic resistance testing from a laboratory that performs nucleic acid analysis and culture-based drug susceptibility testing. A specimen (plasma or tissue-derived viral isolate) is collected and sent to a reference virology lab. In the laboratory workflow, a lab analyst extracts nucleic acids from the sample, performs culture and phenotypic assays to assess HIV-1 susceptibility to antiretroviral agents, and reports resistance results for up to the first 10 drugs tested. Results are returned to the ordering clinician to guide selection of an effective antiretroviral regimen.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|
87903 | The lab analyst performs the technical lab test to analyze the nucleic acids from a sample of tissue from an HIV 1 positive patient to determine drug resistance through culture analysis for up to the first 10 drugs tested. | Primary technical service for culture-based HIV-1 drug resistance testing; billed for the lab performance of the assay. |
87904 | Laboratory analysis for HIV-1 drug resistance by phenotypic methods for additional drugs beyond the first 10 tested (hypothetical companion code). | May be used when more than 10 drugs are evaluated or for additional phenotypic panels following initial testing.
87661 | Infectious agent detection by nucleic acid (e.g., HIV-1 RNA), amplified probe technique, quantitative. | Often performed prior to or concurrently with resistance testing to quantify viral load and confirm specimen suitability for phenotypic assays.
87663 | HIV-1 quantification, viral load testing via nucleic acid; used in monitoring therapy response. | Viral load measurement informs interpretation of resistance testing and clinical decision-making.
87389 | Antibody/antigen detection assays for HIV may be part of the diagnostic workflow before resistance testing. | Used earlier in the diagnostic pathway; less directly related but may appear in the patient's testing history.