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HIV (Human Immunodeficiency Virus) Screening for Adolescents and Adults

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/preventive-care-services.pdf


Service:

USPSTF: United States Preventative Services Task Force


The USPSTF recommends that clinicians screen for HIV infection in

  • Adolescents and adults aged 15-65 years. Younger adolescents and older adults who are at increased risk of infection should also be screened.

  • All Pregnant persons, including those who present in labor or at delivery whose HIV status is unknown.

Note: Bright Futures recommends HIV screening lab work be conducted at least once between ages 15-21 years. Also recommended anytime between ages 11-14 , when a risk assessment is positive. And after initial screening, youth at increased risk of HIV infection should be retested annually or more frequently if at high risk.


Procedure Code(s):

87537, 87538, 87539, 87806, G0432, G0433, G0435, G0475, S3645


Blood Draw:

36415, 36416


Diagnosis Code(s):

Pregnancy:

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/attachments/preventive-care-services-dx-code-list.pdf


Or


Screening:

Adult: Z00.00, Z00.1

Child: Z00.121, Z00.129

Other: Z11.3, Z11.4, Z11.59, Z11.9, Z20.2, Z20.6, Z22.6, Z22.9, Z29.81, Z72.51, Z72.52, Z72.53


Also See Expanded Women's Preventative Heatlh section.


Preventive Benefit Instructions:

No age limits


HIV –Human Immunodeficiency Virus Screening:

Requires a Pregnancy Diagnosis Code

https://www.uhcprovider.com/content/dam/provider/docs/public/policies/attachments/preventive-care-services-dx-code-list.pdf

Or one of the Screening diagnosis codes listed above


Blood Draw:

Requires both of the following:

  • One of the listed HIV Screening procedure codes listed above

And

  • One of the Screening diagnosis codes listed above or a Pregnancy Diagnosis Code listed above.

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