CPT 87912 Hepatitis B Genotype Reimbursement

CPT code 87912 covers molecular laboratory testing for hepatitis B virus genotype analysis using nucleic acid (DNA or RNA) methods. This code identifies the technical laboratory component for genotyping assays that determine HBV strain variants, which can inform clinical characterization and may influence treatment selection and public health surveillance. Nationally, accurate coding for molecular virology tests supports appropriate claim adjudication and epidemiologic tracking of hepatitis B genotypes.

Key payers referenced in this profile include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The overview highlights payer coverage considerations and common modality contexts for laboratory reimbursement.

Readers will find a concise description of the clinical and laboratory context for CPT code 87912, expected sites of service, and the scope of services represented by the code. The publication includes benchmarking and utilization context where available, common modifiers used with laboratory technical services, and policy or billing updates relevant to molecular diagnostic coding. Data not provided in the input (such as associated taxonomies, specific ICD-10 pairings, and payer-specific fee schedules) is identified as not available in the input.

Billing Code Overview

CPT code 87912 describes a laboratory test in which a lab analyst performs the technical procedures to analyze a specimen for hepatitis B virus genotyping using nucleic acid methods (DNA or RNA). The assay determines the viral genotype from patient specimens to inform clinical characterization and potential therapeutic decision-making.

Service type: Genotypic laboratory testing (molecular diagnostic assay)

Typical site of service: Clinical laboratory or hospital laboratory (laboratory-based testing facility)

Clinical Context

A 48-year-old patient with known chronic hepatitis B infection presents for evaluation after a detectable hepatitis B viral load and suspected antiviral treatment failure. The clinician orders genotype analysis to identify viral mutations and inform antiviral selection. A blood specimen is collected in the outpatient phlebotomy clinic or inpatient ward and sent to the molecular diagnostics laboratory. The lab analyst performs 87912 — nucleic acid genotype analysis of hepatitis B virus (HBV) using extracted viral DNA/RNA. The process includes specimen accessioning, nucleic acid extraction, PCR amplification and sequencing or probe-based genotyping, data analysis, and reporting of identified genotypes and resistance-associated mutations. Results are transmitted to the ordering clinician, who integrates genotype findings with clinical history and prior therapy to determine next steps in care.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional (interpretation) component if the lab separates technical and professional components.
`TC`	Technical component

Taxonomy Code	Specialty	Notes
`0000C0`	Clinical Laboratory Scientist	Performs and supervises molecular diagnostic testing (representative taxonomy).
`0000B3`	Pathology	Pathologists interpret molecular test results and provide professional component.
`0000XH`	Infectious Disease	Ordering specialty that commonly requests HBV genotype testing to guide therapy.
`0000M0`	Medical Laboratory Technician	Technical staff performing nucleic acid extraction and assay setup.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`B18.1`	Chronic viral hepatitis B with delta-agent	Chronic HBV infections requiring genotyping to guide long-term antiviral therapy.
`B18.0`	Chronic viral hepatitis B without delta-agent	Common indication for HBV genotype testing to evaluate antiviral resistance or treatment planning.
`B16.9`	Acute hepatitis B without hepatic coma	In select acute cases with atypical course, genotype may be obtained for epidemiology or resistance evaluation.
`Z21`	Asymptomatic human immunodeficiency virus [HIV] status	Patients with HIV coinfection may require HBV genotype testing when treating coinfections.
`B20`	Human immunodeficiency virus [HIV] disease	HIV-positive patients co-infected with HBV commonly undergo HBV genotyping to guide therapy with potential drug interactions.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87624`	Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C virus, amplified probe technique	Performed when evaluating co-infection with hepatitis C or as part of broader viral genotyping panels.
`87536`	Infectious agent detection by nucleic acid (DNA or RNA); human immunodeficiency virus 1, quantification	May be ordered concurrently in patients with suspected or known HIV coinfection affecting management.
`84403`	Viral load measurement; hepatitis B virus, quantitative	Quantitative HBV viral load testing is commonly performed before or after genotype testing to assess viral replication and treatment response.
`89398`	Molecular pathology procedure, level IV (eg, DNA sequencing)	Used for sequencing-based methods that may complement or be reported with genotype analysis.
`U0003`	CDC real-time RT-PCR for SARS-CoV-2	Example of contemporaneous molecular testing in the lab; not specific to HBV but commonly run in molecular labs alongside other assays.

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Summary & Overview

CPT 87912: Hepatitis B Virus Genotype Analysis, Nucleic Acid