How To Use CPT Code 0112U

CPT 0112U describes a proprietary laboratory analysis (PLA) test that is used to detect and identify infectious bacteria and fungi, as well as determine antibiotic resistance. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0112U.

1. What is CPT Code 0112U?

CPT 0112U is a unique laboratory test that is used to detect and identify infectious bacteria and fungi in patients suspected to have an infection that cannot be confirmed by culture or that is suspicious for drug resistance. This test utilizes quantitative PCR for rapid screening and next-generation sequencing with 16S and 18S rRNA genes as targets to identify the infectious agents. It also determines the presence or absence of drug-resistant genes for eight antibiotic classes.

2. Official Description

The official description of CPT code 0112U is: ‘Infectious agent detection and identification, targeted sequence analysis (16S and 18S rRNA genes) with drug-resistance gene.’

3. Procedure

1. The laboratory analyst processes the specimen from a direct source, such as blood, feces, urine, or swabs.
2. Amplification techniques, such as polymerase chain reaction (PCR), are performed to increase the number of copies of the target nucleic acid sequence (16S and 18S rRNA genes).
3. Next-generation sequencing with targeted sequence analysis of the 16S and 18S rRNA genes is used to identify bacterial and fungal infectious agents, respectively.
4. The presence or absence of drug-resistant genes for eight antibiotic classes is determined.

4. Qualifying circumstances

CPT 0112U is used for patients suspected to have an infection that cannot be confirmed by culture or that is suspicious for drug resistance. It is ordered by clinicians in conjunction with other tests to aid in the detection and identification of infectious bacteria and fungi. The test is performed on human specimens and is specific to the MicroGenDX® qPCR & NGS for Infection test from MicroGenDX®.

5. When to use CPT code 0112U

CPT code 0112U should be used when there is a suspicion of infection that cannot be confirmed by culture or when drug resistance is suspected. It is important to note that this code should only be used for the specific proprietary test mentioned above and should not be reported with any other CPT codes.

6. Documentation requirements

To support a claim for CPT code 0112U, the following documentation is required:

• Indication of the suspicion of infection that cannot be confirmed by culture or suspicion of drug resistance
• Specific information about the test performed, including the use of quantitative PCR and next-generation sequencing with targeted sequence analysis of the 16S and 18S rRNA genes
• Date of service and the specimen analyzed
• Results of the test, including the identification of infectious agents and the presence or absence of drug-resistant genes
• Signature of the laboratory analyst performing the test

7. Billing guidelines

When billing for CPT code 0112U, ensure that the test is performed by the specific laboratory mentioned above. Report one unit of this code for a single specimen analyzed on a single date of service. It is important to check with the appropriate payer as some may pay separately for the collection of the specimen. Do not report this test with any other CPT codes.

8. Historical information

CPT code 0112U 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 presents with symptoms of a respiratory infection that cannot be confirmed by culture. CPT code 0112U is used to detect and identify the infectious agents and determine if there is any drug resistance.
2. A patient with recurrent urinary tract infections undergoes CPT code 0112U to identify the bacteria causing the infections and determine if there are any drug-resistant genes present.
3. A patient with a suspected fungal infection that cannot be confirmed by culture undergoes CPT code 0112U to identify the specific fungal species and determine if there are any drug-resistant genes.
4. A patient with a suspected bacterial infection that is suspicious for drug resistance undergoes CPT code 0112U to identify the bacteria causing the infection and determine if there are any drug-resistant genes present.
5. A patient with a suspected infection of unknown origin undergoes CPT code 0112U to detect and identify the infectious agents and determine if there is any drug resistance.
6. A patient with a suspected drug-resistant infection undergoes CPT code 0112U to identify the infectious agents and determine if there are any drug-resistant genes present.
7. A patient with a suspected bacterial or fungal infection that cannot be confirmed by culture undergoes CPT code 0112U to detect and identify the infectious agents and determine if there is any drug resistance.
8. A patient with a suspected infection that is suspicious for drug resistance undergoes CPT code 0112U to identify the infectious agents and determine if there are any drug-resistant genes present.
9. A patient with a suspected bacterial or fungal infection of unknown origin undergoes CPT code 0112U to detect and identify the infectious agents and determine if there is any drug resistance.
10. A patient with a suspected drug-resistant infection of unknown origin undergoes CPT code 0112U to identify the infectious agents and determine if there are any drug-resistant genes present.