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HCPCS G0432: HIV-1/HIV-2 Antibody Screening by EIA

HCPCS Level II code G0432 represents an enzyme immunoassay (EIA) screening test for antibodies to HIV-1 and/or HIV-2. As a routine laboratory screening pathway, this code supports public health efforts to identify HIV infection early and guide linkage to care. Nationally, HIV screening remains a priority for prevention and early treatment, and G0432 is used in ambulatory and community settings where specimens are collected and analyzed in clinical laboratories.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the test, common billing and coverage patterns across major payers, and the contexts in which G0432 is typically reported. The publication also summarizes benchmarks and policy considerations relevant to laboratory screening for HIV, notes common modifier usage where applicable, and outlines typical sites of service and clinical scenarios for reporting this code.

Data not available in the input is noted where payer-specific rates, associated taxonomies, and precise ICD-10 mappings are not provided.

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Billing Code Overview

HCPCS Level II code G0432 describes infectious agent antibody detection by enzyme immunoassay (EIA) technique for HIV-1 and/or HIV-2, screening. This service is a laboratory screening test that detects antibodies to HIV-1 and HIV-2 using an enzyme immunoassay method.

Service type: Laboratory diagnostic screening test
Typical site of service: Clinical laboratory, outpatient clinic, community health center, or other ambulatory care settings where specimen collection and laboratory testing occur

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HCPCS G0432: HIV-1/HIV-2 Antibody Screening by EIA

Data not available in the input is noted where payer-specific rates, associated taxonomies, and precise ICD-10 mappings are not provided.

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Billing Code Overview

Service type: Laboratory diagnostic screening test
Typical site of service: Clinical laboratory, outpatient clinic, community health center, or other ambulatory care settings where specimen collection and laboratory testing occur

Clinical & Coding Specifications

Clinical Context

A 28-year-old sexually active patient presents to a primary care clinic requesting routine screening for HIV. The clinician documents sexual history and risk assessment, obtains informed consent, and collects a venous blood specimen. The specimen is sent to the laboratory where an enzyme immunoassay (EIA) for HIV-1 and/or HIV-2 antibodies is performed using an automated platform. Negative EIA results are reported to the ordering provider and patient with routine counseling. Reactive or repeatedly reactive EIA results trigger reflex confirmatory testing per laboratory protocol (e.g., HIV-1/HIV-2 differentiation immunoassay or HIV-1 RNA testing). Typical workflow steps: patient encounter and order entry, specimen collection and labeling, transport to clinical laboratory, performance of G0432 test, result verification by laboratory personnel, reporting to provider, and follow-up counseling or confirmatory testing as indicated.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the professional component (interpretation) is billed separately from the technical component.
`TC`	Technical component	Use when only the technical component (laboratory processing) is billed.
`59`	Distinct procedural service	Use when bundling edits require separation of a distinct service unrelated to other services on the same day.
`52`	Reduced services	Use when the test was partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the test was started but discontinued due to patient or technical reasons.
`90`	Reference (outside) laboratory	Use when the test was performed by an outside or reference laboratory and only reporting is done locally.
`QX`	CLIA waived personnel performing test (modality-specific)	Use when a specific qualified laboratory personnel performed the testing under CLIA-based modifier requirements.
`QK`	Personal who performed the test (if applicable for specific payor rules)	Use when payor requires identification of the individual performer per contractual rules.
`GA`	Waiver of liability statement on file	Use when the patient has signed an Advance Beneficiary Notice or equivalent and payer requires documentation.
`AS`	Physician or other qualified health care professional Services furnished in accordance with an employer-employee arrangement	Use when services are furnished by a provider under employer arrangement per payer rules.

Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary care providers commonly order HIV screening tests.
`208D00000X`	General Internal Medicine	Internal medicine physicians screen adult patients for HIV in ambulatory settings.
`363LF0000X`	Clinical Laboratory	Clinical laboratory personnel and laboratories perform and report the `G0432` EIA testing.
`261QP2300X`	Infectious Disease	Infectious disease specialists manage follow-up and interpretation of reactive screening results.
`208000000X`	Emergency Medicine	Emergency departments may perform HIV screening using lab-based EIA when indicated.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z11.4`	Encounter for screening for human immunodeficiency virus [HIV]	Routine screening indication for ordering `G0432`.
`Z20.6`	Contact with and (suspected) exposure to human immunodeficiency virus [HIV]	Used when testing is performed after a known exposure risk.
`R75`	Inconclusive laboratory evidence of human immunodeficiency virus [HIV]	Used when initial EIA screening is reactive/inconclusive and further testing is indicated.
`Z71.7`	Human immunodeficiency virus [HIV] counseling	Documentation code used when counseling accompanies HIV screening `G0432`.
`A64`	Unspecified sexually transmitted disease	May be used when testing is part of evaluation for possible sexually transmitted infections including HIV.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Performed immediately before `G0432` to obtain the specimen for HIV EIA screening.
`81025`	Urinalysis, non-automated dipstick	May be performed as part of broader STD screening panels during the same encounter (not specific to `G0432`).
`86701`	Antibody; HIV-1 (confirmatory or differentiation assays vary)	Used for confirmatory testing or differentiation after a reactive `G0432` screening result; laboratory workflow may reflex to these assays.
`87389`	Infectious agent antibody detection by EIA technique, each agent (example code for similar methodology)	Represents EIA methodology codes used in provider documentation and lab panels related to `G0432` screening workflows.
`86497`	HIV-1/HIV-2 antigen/antibody combination immunoassay	Used in some workflows as an initial screening alternative or follow-up assay in diagnostic algorithms associated with `G0432` screening.

HCPCS G9490: Home Visit Assessment for Non-Homebound Patients

HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

HCPCS G0008: Influenza Virus Vaccine Administration

HCPCS-G0009-PNEUMOCOCCAL-VACCINE-ADMINISTRATION

HCPCS G0009: Administration of Pneumococcal Vaccine

HCPCS-G0010-HEPATITIS-B-VACCINE-ADMINISTRATION

HCPCS G0010: Administration of Hepatitis B Vaccine

HCPCS-G0011-PREP-COUNSELING-HIV-RISK-REDUCTION-ADHERENCE

HCPCS G0011: Individual PrEP Counseling, HIV Risk Assessment

HCPCS-G0012-PRE-EXPOSURE-PROPHYLAXIS-INJECTION-HIV-PREVENTION

HCPCS G0012: Injection of Pre-Exposure Prophylaxis (PrEP) for HIV Prevention

HCPCS-G0013-PREP-INDIVIDUAL-COUNSELING-HIV-RISK-REDUCTION

HCPCS G0013: Individual PrEP Counseling and HIV Risk Assessment

HCPCS-G0017-PSYCHOTHERAPY-CRISIS-FIRST-60-MINUTES-NON-OFFICE

HCPCS G0017: Psychotherapy for Crisis, First 60 Minutes

HCPCS-G0018-PSYCHOTHERAPY-CRISIS-ADDITIONAL-30-MINUTES-NON-OFFICE

HCPCS G0018: Psychotherapy for Crisis, Additional 30 Minutes

HCPCS-G0019-COMMUNITY-HEALTH-INTEGRATION-SDOH-CARE-COORDINATION

HCPCS G0019: Community Health Integration for Social Determinants of Health

Showing 1–10 of 1996

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the professional component (interpretation) is billed separately from the technical component.
`TC`	Technical component	Use when only the technical component (laboratory processing) is billed.
`59`	Distinct procedural service	Use when bundling edits require separation of a distinct service unrelated to other services on the same day.
`52`	Reduced services	Use when the test was partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the test was started but discontinued due to patient or technical reasons.
`90`	Reference (outside) laboratory	Use when the test was performed by an outside or reference laboratory and only reporting is done locally.
`QX`	CLIA waived personnel performing test (modality-specific)	Use when a specific qualified laboratory personnel performed the testing under CLIA-based modifier requirements.
`QK`	Personal who performed the test (if applicable for specific payor rules)	Use when payor requires identification of the individual performer per contractual rules.
`GA`	Waiver of liability statement on file	Use when the patient has signed an Advance Beneficiary Notice or equivalent and payer requires documentation.
`AS`	Physician or other qualified health care professional Services furnished in accordance with an employer-employee arrangement	Use when services are furnished by a provider under employer arrangement per payer rules.

Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary care providers commonly order HIV screening tests.
`208D00000X`	General Internal Medicine	Internal medicine physicians screen adult patients for HIV in ambulatory settings.
`363LF0000X`	Clinical Laboratory	Clinical laboratory personnel and laboratories perform and report the `G0432` EIA testing.
`261QP2300X`	Infectious Disease	Infectious disease specialists manage follow-up and interpretation of reactive screening results.
`208000000X`	Emergency Medicine	Emergency departments may perform HIV screening using lab-based EIA when indicated.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z11.4`	Encounter for screening for human immunodeficiency virus [HIV]	Routine screening indication for ordering `G0432`.
`Z20.6`	Contact with and (suspected) exposure to human immunodeficiency virus [HIV]	Used when testing is performed after a known exposure risk.
`R75`	Inconclusive laboratory evidence of human immunodeficiency virus [HIV]	Used when initial EIA screening is reactive/inconclusive and further testing is indicated.
`Z71.7`	Human immunodeficiency virus [HIV] counseling	Documentation code used when counseling accompanies HIV screening `G0432`.
`A64`	Unspecified sexually transmitted disease	May be used when testing is part of evaluation for possible sexually transmitted infections including HIV.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Performed immediately before `G0432` to obtain the specimen for HIV EIA screening.
`81025`	Urinalysis, non-automated dipstick	May be performed as part of broader STD screening panels during the same encounter (not specific to `G0432`).
`86701`	Antibody; HIV-1 (confirmatory or differentiation assays vary)	Used for confirmatory testing or differentiation after a reactive `G0432` screening result; laboratory workflow may reflex to these assays.
`87389`	Infectious agent antibody detection by EIA technique, each agent (example code for similar methodology)	Represents EIA methodology codes used in provider documentation and lab panels related to `G0432` screening workflows.
`86497`	HIV-1/HIV-2 antigen/antibody combination immunoassay	Used in some workflows as an initial screening alternative or follow-up assay in diagnostic algorithms associated with `G0432` screening.

HCPCS G9490: Home Visit Assessment for Non-Homebound Patients

HCPCS-G0008-INFLUENZA-VACCINE-ADMINISTRATION

HCPCS G0008: Influenza Virus Vaccine Administration

HCPCS-G0009-PNEUMOCOCCAL-VACCINE-ADMINISTRATION

HCPCS G0009: Administration of Pneumococcal Vaccine

HCPCS-G0010-HEPATITIS-B-VACCINE-ADMINISTRATION

HCPCS G0010: Administration of Hepatitis B Vaccine

HCPCS-G0011-PREP-COUNSELING-HIV-RISK-REDUCTION-ADHERENCE

HCPCS G0011: Individual PrEP Counseling, HIV Risk Assessment

HCPCS-G0012-PRE-EXPOSURE-PROPHYLAXIS-INJECTION-HIV-PREVENTION

HCPCS G0012: Injection of Pre-Exposure Prophylaxis (PrEP) for HIV Prevention

HCPCS-G0013-PREP-INDIVIDUAL-COUNSELING-HIV-RISK-REDUCTION

HCPCS G0013: Individual PrEP Counseling and HIV Risk Assessment

HCPCS-G0017-PSYCHOTHERAPY-CRISIS-FIRST-60-MINUTES-NON-OFFICE

HCPCS G0017: Psychotherapy for Crisis, First 60 Minutes

HCPCS-G0018-PSYCHOTHERAPY-CRISIS-ADDITIONAL-30-MINUTES-NON-OFFICE

HCPCS G0018: Psychotherapy for Crisis, Additional 30 Minutes

HCPCS-G0019-COMMUNITY-HEALTH-INTEGRATION-SDOH-CARE-COORDINATION

HCPCS G0019: Community Health Integration for Social Determinants of Health

Showing 1–10 of 1996

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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HCPCS G0432: HIV-1/HIV-2 Antibody Screening by EIA

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Billing Code Overview

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HCPCS G0432: HIV-1/HIV-2 Antibody Screening by EIA

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

HCPCS G0432: HIV-1/HIV-2 Antibody Screening by EIA

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Billing Code Overview

HCPCS G0432: HIV-1/HIV-2 Antibody Screening by EIA

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code G0432 represent?

What are the common clinical and laboratory workflow steps when G0432 is performed?

Which billing modifiers are relevant for reporting G0432?

What CPT codes are commonly associated with G0432 in the testing pathway?

Which ICD-10 diagnosis codes are relevant when ordering or documenting G0432?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code G0432 represent?

What are the common clinical and laboratory workflow steps when G0432 is performed?

Which billing modifiers are relevant for reporting G0432?

What CPT codes are commonly associated with G0432 in the testing pathway?

Which ICD-10 diagnosis codes are relevant when ordering or documenting G0432?

References