The Pathology: Microbiology section of the Part 2 provider manual was updated with new guidelines for providers billing an initial test with Trofile using CPT-4 code 87999 (unlisted microbiology procedure).
The new guidelines state that the indication for a Trofile test is based on Guidelines for the Use of Anti-retroviral Agents In HIV-1 Infected Adults and Adolescents developed by the U.S. Department of Health and Human Services (HHS) Panel on â€œAnti-retroviral Guidelines for Adults and Adolescents â€“ A Working Groupâ€ of the Office of AIDS Research Advisory Council (OARAC).
The first Trofile test will be reimbursed when providers document the following items:
- The use of a CCR5 inhibitor is being considered, or
- The patient exhibits virologic failure on a CCR5 inhibitor.
Source: General Medicine | August 2010 | Bulletin 434