Wiki NEW HPV CPTs - which are you using?

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NOT EFFECTIVE:
87620 Infectious agent detection by nucleic acid (DNA or RNA); papillomavirus, human, direct probe
technique
87621 papillomavirus, human, amplified probe technique
87622 papillomavirus, human, quantification

NEW CODES:
87623 Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), low-risk
types (eg, 6, 11, 42, 43, 44)
87624 Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68)
87625 Human Papillomavirus (HPV), types 16 and 18 only, includes type 45, if performed
(When both low-risk and high-risk HPV types are performed in a single assay, use only 87624)
 
Last edited:
87624

When billing HPV Genotyping and for expanded HPV Genotype are you billing your commercial carriers units greater than 1? CMS has a MUE of 1 but could the commercial payers possibly pay units greater and if so what is the risk of recoupment?

Thank you,
 
It depends on the assay to be correctly billed. If two different assays are being performed to obtain the result i.e, a detection followed by a genotype specific assay you have a better chance to sustain a decision. If both steps are performed in one assay (procedure) it does not seem appropriate to bill two charges for one result.
 
87624 Currently Denied by Aetna as pass through billing

Code getting denied by Aetna as pass-through billing and provider type may not bill for this service? What are we missing? We are institutional services. Please advise Thank you

NEW CODES:
87624 Human Papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68)
 
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