How To Use CPT Code 0115U

CPT 0115U describes a specific laboratory test used to detect respiratory infectious agents by nucleic acid amplification. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0115U?

CPT 0115U is a unique code that represents a laboratory test used to detect respiratory infectious agents through the amplification of nucleic acid. This test specifically identifies 18 viral types and subtypes, as well as 2 bacterial targets. The results of the test indicate whether each analyte is detected or not detected in the sample.

2. Official Description

The official description of CPT code 0115U states that it is a respiratory infectious agent detection test using nucleic acid amplification. This test utilizes an amplified probe technique, including multiplex reverse transcription for RNA targets. The test reports the presence or absence of each of the 18 viral types and subtypes, as well as the 2 bacterial targets.

3. Procedure

1. The laboratory analyst prepares a nasopharyngeal specimen obtained from a patient suspected to have a respiratory tract infection.
2. The specimen is placed in the ePlex® system, which is an automated laboratory panel.
3. The ePlex® system performs nucleic acid extraction and amplification of the target DNA or RNA sequences using polymerase chain reaction (PCR) or reverse transcription PCR (RT-PCR).
4. The system then hybridizes the target DNA with specific probes labeled with markers, such as fluorescent dyes.
5. The ePlex® system generates a detection report for each targeted analyte, indicating whether it is detected or not detected in the specimen.

4. Qualifying circumstances

CPT code 0115U is used for patients suspected to have respiratory tract infections. The test can detect 18 viral types and subtypes, as well as 2 bacterial targets. It is important to note that this code specifically applies to the ePlex® Respiratory Pathogen (RP) Panel from GenMark Diagnostics, Inc. Other ePlex® panels, such as blood culture, CNS, GI, or HCV panels, should not be reported with this code.

5. When to use CPT code 0115U

CPT code 0115U should be used when a clinician orders the ePlex® Respiratory Pathogen (RP) Panel test for a patient suspected to have a viral or bacterial respiratory infection. This code is specific to the proprietary test offered by GenMark Diagnostics, Inc. It should not be reported with any other CPT code.

6. Documentation requirements

To support a claim for CPT code 0115U, the documentation should include:

• Indication for ordering the test, such as suspicion of a viral or bacterial respiratory infection
• Details of the ePlex® Respiratory Pathogen (RP) Panel test performed
• Date of service
• Results of the test, indicating whether each analyte was detected or not detected

7. Billing guidelines

When billing for CPT code 0115U, ensure that the test performed is the ePlex® Respiratory Pathogen (RP) Panel from GenMark Diagnostics, Inc. This code should not be reported with any other CPT code. Use one unit of this code for a single specimen analyzed on a single date of service.

8. Historical information

CPT code 0115U was added to the Current Procedural Terminology system on October 1, 2019. There have been no updates or changes to the code since its addition.

9. Examples

1. A clinician orders the ePlex® Respiratory Pathogen (RP) Panel test for a patient presenting with symptoms of a respiratory infection. The test results indicate the presence of Influenza A, Influenza B, and Respiratory Syncytial Virus A, while the bacterial targets Chlamydia pneumoniae and Mycoplasma pneumoniae are not detected.
2. Another patient with respiratory symptoms undergoes the ePlex® Respiratory Pathogen (RP) Panel test. The results show the presence of Coronavirus NL63, human Rhinovirus/Enterovirus, and Parainfluenza 3, while the bacterial targets Chlamydia pneumoniae and Mycoplasma pneumoniae are not detected.
3. A third patient suspected to have a respiratory infection undergoes the ePlex® Respiratory Pathogen (RP) Panel test. The results indicate the presence of Adenovirus, human Metapneumovirus, and Influenza A H3, while the bacterial targets Chlamydia pneumoniae and Mycoplasma pneumoniae are not detected.