How To Use CPT Code 0062U

CPT 0062U describes the analysis of 80 biomarkers to determine the risk of systemic lupus erythematosus (SLE) using a proprietary test called SLE-key® Rule Out. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0062U?

CPT 0062U can be used to analyze 80 biomarkers related to systemic lupus erythematosus (SLE) using the SLE-key® Rule Out test. This proprietary test utilizes serum and an algorithmic analysis to report a risk score for SLE.

2. Official Description

The official description of CPT code 0062U is: ‘Autoimmune (systemic lupus erythematosus), IgG and IgM analysis of 80 biomarkers, utilizing serum, algorithm reported with a risk score.’

3. Procedure

1. The lab analyst applies the patient’s serum to an iCHIP® microarray slide.
2. The slide is then placed in a proprietary reader device for fluorescence detection of 80 IgG and IgM antibody markers.
3. An algorithmic analysis is performed, comparing the patient’s profile to a proprietary database.
4. A risk score is reported to rule out or potentially classify the patient as having SLE.

4. Qualifying circumstances

CPT 0062U is used when clinicians want to rule out a diagnosis of SLE or monitor a patient’s immune profile over time. SLE is an autoimmune disease that causes the body to attack its own connective tissues, resulting in organ damage, joint inflammation, and skin inflammation. The test is performed on human specimens and is specific to the SLE-key® Rule Out test from Veracis Inc.

5. When to use CPT code 0062U

CPT code 0062U should be used when ordering the SLE-key® Rule Out test to analyze 80 biomarkers related to SLE. It is important to note that PLA codes take precedence over the usual 80000 series codes for laboratory/pathology, so this test should not be reported with any other CPT code.

6. Documentation requirements

To support a claim for CPT code 0062U, the following documentation is required:

• Patient’s serum analysis results
• Specific details of the proprietary SLE-key® Rule Out test
• Date of service and patient identification
• Algorithmic analysis and risk score reported
• Signature of the lab analyst performing the test

7. Billing guidelines

When billing for CPT code 0062U, ensure that the test is performed using the SLE-key® Rule Out test from Veracis Inc. Report one unit of this code for a single specimen analyzed on a single date of service. PLA codes take precedence over the usual 80000 series codes, so do not report this test with any other CPT code. It is also important to check with the appropriate payer as some may pay separately for the collection of the specimen.

8. Historical information

CPT code 0062U was added to the Current Procedural Terminology system on October 1, 2018. There have been no updates or changes to the code since its addition.

9. Examples

1. A rheumatologist orders the SLE-key® Rule Out test to analyze 80 biomarkers for a patient presenting with symptoms suggestive of systemic lupus erythematosus.
2. A primary care physician monitors a patient with a known diagnosis of SLE by regularly performing the SLE-key® Rule Out test to track changes in the patient’s immune profile.
3. A dermatologist orders the SLE-key® Rule Out test to rule out a diagnosis of SLE in a patient with skin inflammation and joint pain.
4. An internist utilizes the SLE-key® Rule Out test to assess the risk of SLE in a patient with multiple autoimmune diseases.
5. A nephrologist orders the SLE-key® Rule Out test to evaluate the risk of SLE-related kidney damage in a patient with proteinuria and hematuria.
6. A rheumatologist uses the SLE-key® Rule Out test to monitor the response to therapy in a patient with SLE.
7. A family physician orders the SLE-key® Rule Out test to rule out a diagnosis of SLE in a patient with fatigue, joint pain, and a positive antinuclear antibody test.
8. An immunologist utilizes the SLE-key® Rule Out test to assess the risk of SLE in a patient with a family history of the disease.
9. A hematologist orders the SLE-key® Rule Out test to evaluate the risk of SLE-related blood disorders in a patient with unexplained anemia and thrombocytopenia.
10. A rheumatologist uses the SLE-key® Rule Out test to monitor disease activity and response to therapy in a patient with SLE.