How To Use CPT Code 0118U

CPT 0118U describes a specific test used in transplantation medicine to quantify donor-derived cell-free DNA using whole genome next-generation sequencing. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0118U.

1. What is CPT Code 0118U?

CPT 0118U can be used to report the Viracor TRAC™ donor-derived cell-free DNA (dd-cfDNA) assay from Viracor Eurofins. This proprietary laboratory analysis (PLA) code is specific to this unique lab test and is used to monitor the percentage of dd-cfDNA in the blood of transplant recipients following a solid organ transplant. The test utilizes next-generation sequencing to provide quantitative measurements of the dd-cfDNA percentage.

2. Official Description

The official description of CPT code 0118U is: ‘Transplantation medicine, quantification of donor-derived cell-free DNA using whole genome next-generation sequencing, plasma, reported as percentage of donor-derived cell-free DNA in the total cell-free DNA.’

3. Procedure

1. The procedure for CPT code 0118U involves collecting whole blood from a patient who has undergone a previous solid organ transplant.
2. The blood is collected in a special tube following a strict protocol and shipped to the laboratory.
3. In the laboratory, the plasma is extracted from the blood sample and prepared for testing.
4. The Viracor TRAC™ dd-cfDNA assay, which utilizes automated next-generation DNA sequencing, is performed to quantify the donor-derived fraction of cell-free DNA.
5. The results of the next-generation sequencing and recipient genotype data are analyzed by a bioinformatics algorithm to calculate the percentage of donor-derived cell-free DNA present in the plasma.

4. Qualifying circumstances

CPT code 0118U is applicable for patients who have undergone a solid organ transplant and require monitoring for the possibility of rejection. The test measures the percentage of donor-derived cell-free DNA in the recipient’s blood, which strongly correlates to allograft injury due to rejection. It is important to note that this test cannot be used for transplant recipients who are identical twins or siblings from parents who share blood relatives, or for patients who have received multiple transplants from different donors. The test is specific to solid organ transplants, including the heart, liver, kidneys, spleen, and pancreas.

5. When to use CPT code 0118U

CPT code 0118U should be used when monitoring the percentage of donor-derived cell-free DNA in the plasma of patients who have undergone a solid organ transplant. It is a valuable tool for assessing the possibility of allograft rejection without the need for invasive organ biopsies. However, it is important to consider the limitations of the test and ensure that the patient’s circumstances align with the qualifying criteria.

6. Documentation requirements

To support a claim for CPT code 0118U, the following documentation is required:

• Indication of the patient’s previous solid organ transplant
• Description of the specific test performed, including the Viracor TRAC™ dd-cfDNA assay
• Date of service and specimen collection
• Results of the next-generation sequencing and calculation of the percentage of donor-derived cell-free DNA
• Signature of the laboratory analyst performing the test

7. Billing guidelines

When billing for CPT code 0118U, it is important to ensure that the test is performed by the specific laboratory offering the Viracor TRAC™ dd-cfDNA assay. The code should be reported for each individual specimen analyzed on a single date of service. It is also advisable to check with the appropriate payer regarding separate payment for specimen collection. Additionally, CPT code 0118U should not be reported with any other CPT code, as it is a proprietary laboratory analysis (PLA) code.

8. Historical information

CPT code 0118U was added to the Current Procedural Terminology system on October 1, 2019. As a relatively new code, there have been no updates or changes since its addition.

9. Examples

1. A patient who has received a kidney transplant undergoes the Viracor TRAC™ dd-cfDNA assay to monitor the percentage of donor-derived cell-free DNA in their plasma.
2. Following a heart transplant, a recipient’s blood is tested using CPT code 0118U to assess the possibility of allograft rejection.
3. A liver transplant recipient undergoes the Viracor TRAC™ dd-cfDNA assay to measure the percentage of donor-derived cell-free DNA in their plasma and monitor for potential rejection.
4. After a pancreas transplant, the percentage of donor-derived cell-free DNA in the recipient’s blood is assessed using CPT code 0118U to evaluate the risk of allograft rejection.
5. A patient who has undergone a spleen transplant undergoes the Viracor TRAC™ dd-cfDNA assay to monitor the percentage of donor-derived cell-free DNA in their plasma and assess the possibility of rejection.
6. Following a solid organ transplant, CPT code 0118U is used to quantify the donor-derived cell-free DNA in the recipient’s plasma and evaluate the risk of allograft rejection.
7. A kidney transplant recipient’s blood is tested using CPT code 0118U to measure the percentage of donor-derived cell-free DNA and monitor for potential rejection.
8. After a heart transplant, the Viracor TRAC™ dd-cfDNA assay is performed to assess the percentage of donor-derived cell-free DNA in the recipient’s plasma and evaluate the risk of allograft rejection.
9. A liver transplant recipient undergoes CPT code 0118U to monitor the percentage of donor-derived cell-free DNA in their plasma and assess the possibility of rejection.
10. Following a pancreas transplant, the percentage of donor-derived cell-free DNA in the recipient’s blood is assessed using CPT code 0118U to evaluate the risk of allograft rejection.