Hepatitis B Virus (HBV) Screening

HCPCS/CPT Codes

Asymptomatic, Non-pregnant Adolescents and High-Risk Adults

G0499 - Hepatitis b antibody screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag result

For Pregnant Women

86704 - Hepatitis B core antibody (HBcAb); total

86706 - Hepatitis B surface antibody (HBsAb)

87340 - Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; hepatitis B surface antigen (HbsAg)

87341 - Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; hepatitis B surface antigen (HbsAg) neutralization

Frequency

  • 1 asymptomatic screening for non-pregnant adolescents and adults who meet high-risk definition
  • Annually for patients with continued high risk who don't get HBV
  • 1 screening for pregnant women at first prenatal visit for each pregnancy, and rescreening at delivery for those with new or continued risk factors
    • This includes pregnant patients who previously got the HBV shot or had a negative hepatitis B surface antigen screening result

Diagnosis Code

Persons with ESRD:

  • Z11.59 and N18.6

Asymptomatic, Non-pregnant Adolescents and High-Risk Adults:

  • Z11.59 and Z72.89

Asymptomatic, Non-pregnant Adolescents and Adults, Subsequent Visits:

Pregnant Women:

  • Z11.59 and 1 of these: Z34.00, Z34.01, Z34.02, Z34.03, Z34.80, Z34.81, Z34.82, Z34.83, Z34.90, Z34.91, Z34.92, Z34.93

High-Risk Pregnant Women:

  • Z11.59 and Z72.89 and 1 of these: O09.90, O09.91, O09.92, O09.93

Coverage

Ordered by primary care physician or practitioner; and

Beneficiary must be either be:

  • High risk for HBV infection, asymptomatic, and non-pregnant:
    • Persons born in regions with a high prevalence of HBV infection
    • US-born persons not vaccinated as infants whose parents were born in regions with a very high prevalence of HBV infection
    • HIV-positive
    • Men who have sex with men
    • Injection drug users
    • Household contacts or sexual partners of persons with HBV infection
  • Pregnant women

Payment

No copayment, coinsurance, or deductible

Noridian Medicare Portal

Yes - G0499

Resources

Last Updated Apr 08 , 2024