How To Use CPT Code 0109U

CPT 0109U describes a specific laboratory test for the detection of DNA from four species of Aspergillus, including A. fumigatus, A. terreus, A. niger, and A. flavus. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0109U.

1. What is CPT Code 0109U?

CPT 0109U is a proprietary laboratory analysis (PLA) code that applies to a specific lab test called the MycoDART-PCR™ Aspergillus diagnostic panel. This test, developed by RealTime Laboratories, Inc./MycoDART, Inc., is a dual amplification real-time PCR panel used to detect the presence or absence of Aspergillus species in blood, lavage fluid, or tissue. The four species targeted by this test are A. fumigatus, A. terreus, A. niger, and A. flavus.

2. Official Description

The official description of CPT code 0109U is: ‘Infectious disease (Aspergillus species), real-time PCR for detection of DNA from 4 species (A. fumigatus, A. terreus, A. niger, and A. flavus), blood, lavage fluid, or tissue, qualitative reporting of presence or absence of each species.’

3. Procedure

1. The laboratory analyst receives a specimen, such as blood, bronchoalveolar lavage (BAL) fluid, or tissue, and processes it for analysis.
2. The analyst performs real-time polymerase chain reaction (PCR) techniques to amplify the DNA of the four targeted Aspergillus species if present in the specimen.
3. Labeled nucleic acid probes are added to the specimen, allowing the analyst to visualize and identify any targets present.
4. The analyst reports the presence or absence of each of the four Aspergillus species in the patient specimen.

4. Qualifying circumstances

CPT 0109U is typically ordered for immunosuppressed patients to aid in the diagnosis of aspergillosis, a fungal infection caused by Aspergillus. Aspergillosis primarily affects the respiratory system and can present with symptoms similar to asthma, the growth of a fungus ball in a lung lesion, pneumonia, or spread to other parts of the body. Individuals with lung diseases, compromised immune systems, or other risk factors are more susceptible to this condition.

5. When to use CPT code 0109U

CPT code 0109U should be used when the MycoDART-PCR™ Aspergillus diagnostic panel is performed to detect the presence or absence of DNA from the four targeted Aspergillus species in blood, lavage fluid, or tissue. This code should only be reported for the specific test described and should not be used with any other CPT codes.

6. Documentation requirements

To support a claim for CPT code 0109U, the laboratory should document the following information:

• Type of specimen analyzed (blood, lavage fluid, or tissue)
• Date of service
• Results of the test, indicating the presence or absence of each of the four Aspergillus species

7. Billing guidelines

When billing for CPT code 0109U, ensure that the test performed is the MycoDART-PCR™ Aspergillus diagnostic panel. This code should not be reported with any other CPT codes. It is important to check with the appropriate payer regarding any additional requirements or coverage policies for this specific test.

8. Historical information

CPT code 0109U was added to the Current Procedural Terminology system on October 1, 2019. There have been no updates to the code since its addition.

9. Examples

1. A patient with a compromised immune system undergoes the MycoDART-PCR™ Aspergillus diagnostic panel to determine the presence or absence of Aspergillus species in their blood.
2. A bronchoalveolar lavage fluid sample is analyzed using the MycoDART-PCR™ Aspergillus diagnostic panel to detect the DNA of Aspergillus species in a patient with suspected aspergillosis.
3. A tissue biopsy is tested using the MycoDART-PCR™ Aspergillus diagnostic panel to confirm the presence or absence of Aspergillus species in a patient with a lung lesion.
4. A patient with symptoms suggestive of aspergillosis undergoes the MycoDART-PCR™ Aspergillus diagnostic panel to aid in the diagnosis of the fungal infection.
5. A blood sample from an immunosuppressed patient is analyzed using the MycoDART-PCR™ Aspergillus diagnostic panel to detect the presence or absence of Aspergillus species.