How To Use CPT Code 0142U

CPT 0142U describes the identification and detection of infectious diseases caused by gram-negative bacteria and fungi using DNA analysis. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0142U?

CPT 0142U can be used to identify and detect infectious diseases caused by gram-negative bacteria and fungi. This code utilizes DNA analysis to detect 21 gram-negative bacterial targets, 6 resistance genes, 1 pan gram-positive bacterial target, and 1 pan Candida target. The test is performed using an amplified probe technique to determine if the targets are detected or not detected in the specimen.

2. Official Description

The official description of CPT code 0142U is: ‘Infectious disease (bacteria and fungi), gram-negative bacterial identification and drug resistance element detection, DNA (21 gram-negative bacterial targets, 6 resistance genes, 1 pan gram-positive bacterial target, 1 pan Candida target), amplified probe technique, each target reported as detected or not detected.’

3. Procedure

1. The laboratory analyst utilizes an automated amplified probe technique to analyze the blood culture specimen for the presence of 21 gram-negative bacterial targets, 6 resistance genes, 1 pan gram-positive bacterial target, and 1 pan Candida target.
2. The DNA in the specimen is amplified to make more copies for study.
3. The amplified DNA is then subjected to hybridization with specific probes to detect the presence or absence of the targeted bacteria and resistance genes.
4. The results are reported for each target as either detected or not detected.

4. Qualifying circumstances

CPT 0142U is used for patients suspected to have a gram-negative bacterial blood infection. It aids in the rapid diagnosis of the infection and helps guide the selection of targeted antimicrobial therapy. This test is performed on human specimens requested by the clinical lab offering the test, using the specific proprietary ePlex® BCID gram-negative panel from GenMark Diagnostics Inc.

5. When to use CPT code 0142U

CPT code 0142U should be used when there is a suspicion of a gram-negative bacterial blood infection and when the clinician desires a rapid diagnosis to aid in selecting appropriate antimicrobial therapy. This code should only be reported for the specific proprietary test described, and not with any other CPT code.

6. Documentation requirements

To support a claim for CPT code 0142U, the following documentation is required:

• Order for the test from the clinician
• Date of service
• Results of the test, indicating which targets were detected or not detected

7. Billing guidelines

When billing for CPT code 0142U, ensure that the test is performed using the specific proprietary ePlex® BCID gram-negative panel from GenMark Diagnostics Inc. Report one unit of this code for each specimen analyzed on a single date of service. Do not report this test with any other CPT code. Some payers may separately reimburse for the collection of the specimen, so it is important to check with the appropriate payer.

8. Historical information

CPT code 0142U was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A patient presents with symptoms of a severe infection, and the clinician suspects a gram-negative bacterial blood infection. The ePlex® BCID gram-negative panel is ordered, and the results indicate the presence of several gram-negative bacterial targets and resistance genes.
2. A patient with a compromised immune system develops a fever, and the clinician suspects a fungal infection. The ePlex® BCID gram-negative panel is performed, and the results show the presence of a pan Candida target, indicating a fungal infection.
3. A patient in the intensive care unit develops sepsis, and the clinician orders the ePlex® BCID gram-negative panel to identify the causative bacteria. The results indicate the presence of multiple gram-negative bacterial targets, guiding the selection of appropriate antimicrobial therapy.
4. A patient with a history of recurrent urinary tract infections presents with symptoms of another infection. The ePlex® BCID gram-negative panel is performed, and the results show the presence of a specific gram-negative bacterial target, confirming the diagnosis.
5. A patient with a suspected bloodstream infection undergoes the ePlex® BCID gram-negative panel, and the results indicate the absence of any targeted bacteria or resistance genes, ruling out a gram-negative bacterial infection.
6. A patient with a wound infection is tested using the ePlex® BCID gram-negative panel, and the results show the presence of a specific gram-negative bacterial target, confirming the source of the infection.
7. A patient with a history of respiratory infections presents with worsening symptoms. The ePlex® BCID gram-negative panel is performed, and the results indicate the presence of a specific gram-negative bacterial target, guiding the selection of appropriate antimicrobial therapy.
8. A patient with a suspected bloodstream infection undergoes the ePlex® BCID gram-negative panel, and the results indicate the absence of any targeted bacteria or resistance genes, ruling out a gram-negative bacterial infection.
9. A patient with a suspected bloodstream infection undergoes the ePlex® BCID gram-negative panel, and the results indicate the absence of any targeted bacteria or resistance genes, ruling out a gram-negative bacterial infection.
10. A patient with a suspected bloodstream infection undergoes the ePlex® BCID gram-negative panel, and the results indicate the absence of any targeted bacteria or resistance genes, ruling out a gram-negative bacterial infection.