How To Use CPT Code 0059U

CPT 0059U describes the detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1) in serum, reported as positive or negative. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0059U?

CPT 0059U can be used to detect antibodies to the Merkel cell polyoma virus capsid protein (VP1) in serum. This test determines whether a patient has been exposed to the Merkel cell polyomavirus, but it does not necessarily indicate the presence of Merkel cell carcinoma (MCC).

2. Official Description

The official description of CPT code 0059U is: ‘Oncology (Merkel cell carcinoma), detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1), serum, reported as positive or negative.’

3. Procedure

1. The lab analyst separates the serum from the blood specimen.
2. The analyst uses fluorescence and multiplex bead technology to detect antibodies to the Merkel cell polyoma virus capsid protein (VP1) in the serum.
3. A piece of the MC oncoprotein is attached to beads, which immobilizes it.
4. The serum is exposed to the oncoprotein, and antibodies, if present, attach to the fragment of oncoprotein.
5. The analyst washes away all other proteins, leaving only the antibodies attached to the oncoprotein.
6. A fluorescent probe is applied to the beads, and the analyst examines them to determine if antibodies are present.
7. A positive result indicates exposure to the polyomavirus, while a negative result indicates no exposure.

4. Qualifying circumstances

CPT 0059U is ordered for patients suspected to have exposure to the Merkel cell polyomavirus. It is important to note that a positive result does not necessarily indicate the presence of Merkel cell carcinoma, but rather exposure to the virus.

5. When to use CPT code 0059U

CPT code 0059U should be used when a clinician wants to determine if a patient has been exposed to the Merkel cell polyomavirus. It is not appropriate to use this code for diagnosing Merkel cell carcinoma, as it only detects the presence of antibodies to the virus capsid protein (VP1).

6. Documentation requirements

To support a claim for CPT code 0059U, the following documentation is required:

• Patient’s suspected exposure to the Merkel cell polyomavirus
• Date of the test
• Result of the test (positive or negative)

7. Billing guidelines

When billing for CPT code 0059U, ensure that the test is performed by the University of Washington, Department of Laboratory Medicine. Report one unit of this code for a single specimen analyzed on a single date of service. It is important to note that this is a proprietary laboratory analysis (PLA) code and should not be reported with any other CPT code.

8. Historical information

CPT code 0059U was added to the Current Procedural Terminology system on July 1, 2018. There have been no updates to the code since its addition.

9. Examples

1. A patient suspected of exposure to the Merkel cell polyomavirus undergoes the detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1) test. The result comes back positive, indicating prior exposure to the virus.
2. A clinician orders the detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1) test for a patient with symptoms suggestive of Merkel cell carcinoma. The test result is negative, indicating no exposure to the virus.
3. A patient with a history of Merkel cell carcinoma undergoes routine monitoring with the detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1) test. The result is positive, confirming prior exposure to the virus.
4. A clinician suspects Merkel cell carcinoma in a patient and orders the detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1) test. The result is negative, indicating no exposure to the virus.
5. A patient with a family history of Merkel cell carcinoma undergoes the detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1) test. The result is positive, suggesting prior exposure to the virus.
6. A clinician orders the detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1) test for a patient with suspicious skin lesions. The result is negative, indicating no exposure to the virus.
7. A patient with a history of Merkel cell carcinoma undergoes regular follow-up visits, including the detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1) test. The result is positive, confirming prior exposure to the virus.
8. A clinician suspects Merkel cell carcinoma in a patient and orders the detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1) test. The result is negative, indicating no exposure to the virus.
9. A patient with a family history of Merkel cell carcinoma undergoes the detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1) test. The result is positive, suggesting prior exposure to the virus.
10. A clinician orders the detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1) test for a patient with suspicious skin lesions. The result is negative, indicating no exposure to the virus.