CPT® Code 87389 is used to report a single immunoassay that detects both HIV-1 p24 antigen and antibodies to HIV-1 and HIV-2. This combined testing method is commonly used for HIV screening and early detection, as it can identify infection earlier than antibody-only tests.
This fourth-generation HIV test is widely used in routine screening, diagnostic evaluation, and post-exposure assessment, depending on clinical context and payer guidelines.
This code represents the laboratory assay only, not specimen collection or counseling/interpretation services, which may be reported separately when appropriate.
Key Facts About CPT® 87389
- Service type: Laboratory immunoassay
- Test: HIV-1 antigen (p24) and HIV-1/HIV-2 antibodies (single combination assay)
- Specimen type: Serum or plasma
- Test purpose: HIV screening and early detection of infection
- Provider type: Laboratories, physicians, and qualified healthcare professionals
Common clinical indications:
- Routine HIV screening in adults and adolescents
- Evaluation of possible HIV exposure
- Prenatal HIV screening
- Occupational exposure follow-up testing
- Evaluation of symptoms consistent with acute or chronic HIV infection
When to Use CPT® 87389
CPT 87389 is appropriate when:
- Performing a combined HIV antigen/antibody screening test
- Screening asymptomatic individuals according to preventive care guidelines
- Evaluating patients after a potential exposure to HIV
- Assessing symptoms suggestive of acute HIV infection
- Conducting prenatal or routine infectious disease screening when indicated
Examples:
- Routine annual HIV screening in a primary care or sexual health visit
- Testing a patient following a needle-stick injury or occupational exposure
- Screening during prenatal care visits
- Evaluating a patient with fever, rash, and suspected acute retroviral syndrome
Documentation Requirements
To support CPT 87389 billing, documentation should include:
- Patient identifiers and date of service
- Clinical indication for HIV testing (screening, exposure, symptoms, etc.)
- Specimen type (serum or plasma)
- Test performed (HIV-1 antigen and HIV-1/HIV-2 antibody immunoassay)
- Test result and date reported
- Ordering provider information
Complete documentation supports medical necessity and appropriate preventive care reporting.
Reimbursement and Coding Considerations
- CPT 87389 is generally covered for routine screening and medically indicated HIV testing
- Often included in preventive care panels depending on payer policies
- Diagnosis coding should reflect screening, exposure risk, or clinical suspicion
- Follow-up confirmatory testing (e.g., HIV differentiation or nucleic acid testing) may be required for reactive results
- Coverage varies by payer and preventive care guidelines (including USPSTF recommendations)
Always verify payer-specific infectious disease testing and preventive screening requirements before submitting claims.
How OptiMantra Supports Infectious Disease Screening
OptiMantra’s integrated EMR and practice management system streamlines documentation and billing for CPT 87389:
With OptiMantra, providers can:
- Order HIV screening tests within the patient chart
- Track infectious disease screening history over time
- Link laboratory results to preventive care and risk-based diagnoses
- Maintain organized laboratory documentation that supports billing compliance and audit preparedness
By centralizing infectious disease screening workflows, OptiMantra helps practices improve efficiency, ensure compliance, and support timely patient care.
Try OptiMantra for free here!
Disclaimer: CPT® codes are maintained by the American Medical Association. This guide is for informational purposes only and does not replace official coding guidelines or payer policies.
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