How To Use CPT Code 0191U

CPT 0191U describes the gene analysis for the CD44 molecule, specifically analyzing exons 2, 3, and 6, to determine the presence or absence of Indian (IN) blood group antigens. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0191U?

CPT 0191U can be used to describe the gene analysis for the CD44 molecule, focusing on exons 2, 3, and 6. This analysis helps determine the presence or absence of Indian (IN) blood group antigens. The test is performed using a patient specimen, such as blood or saliva, and can provide valuable information for clinicians to minimize adverse blood-type incompatibility reactions in various medical scenarios, such as blood transfusions, organ transplants, or during pregnancy and newborn care.

2. Official Description

The official description of CPT code 0191U is: ‘Red cell antigen (Indian blood group) genotyping (IN), gene analysis, CD44 (CD44 molecule [Indian blood group]) exons 2, 3, 6.’

3. Procedure

1. The lab analyst collects a patient specimen, such as blood or saliva, for gene analysis.
2. The CD44 molecule is analyzed, specifically focusing on exons 2, 3, and 6.
3. The analysis involves DNA amplification, often using polymerase chain reaction (PCR) techniques.
4. A Luminex® platform is utilized to identify genetic markers for specific red blood cell antigens in the Indian (IN) blood group.
5. The presence or absence of Indian blood group antigens is determined based on the variation in the CD44 gene.

4. Qualifying circumstances

CPT 0191U is typically ordered for patients who require information about their Indian (IN) blood group antigens. This information is valuable in scenarios where compatibility in transfusions or transplants needs to be ensured, or when minimizing adverse blood reactions or maternal antibody formation during pregnancy and newborn care is necessary. The test can be performed on specimens from blood or tissue donors and recipients, as well as on maternal blood samples.

5. When to use CPT code 0191U

CPT code 0191U should be used when there is a clinical need to determine the presence or absence of Indian (IN) blood group antigens. It is particularly relevant in situations where compatibility in transfusions, transplants, or pregnancy and newborn care needs to be assessed. This code should only be used for the specific gene analysis of the CD44 molecule, focusing on exons 2, 3, and 6.

6. Documentation requirements

To support a claim for CPT 0191U, the following documentation should be included:

• Patient information and specimen source (blood or saliva)
• Date of service
• Details of the gene analysis, specifically focusing on exons 2, 3, and 6 of the CD44 molecule
• Results indicating the presence or absence of Indian (IN) blood group antigens
• Signature of the lab analyst performing the analysis

7. Billing guidelines

When billing for CPT 0191U, ensure that the test is performed by the appropriate lab and for the specific gene analysis of the CD44 molecule. It is important to report one unit of this code for each individual specimen analyzed on a single date of service. Some payers may cover the collection of the specimen separately, so it is advisable to check with the relevant payer. Additionally, be cautious to use the correct code for the specific blood group antigen analysis, as Grifols Immunohematology Center offers multiple proprietary laboratory analyses (PLA) codes for different blood group antigens.

8. Historical information

CPT 0191U was added to the Current Procedural Terminology system on July 1, 2020. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient requires a blood transfusion, and the clinician orders CPT 0191U to determine the presence or absence of Indian (IN) blood group antigens for compatibility assessment.
2. A pregnant woman with a history of adverse blood reactions in previous pregnancies undergoes CPT 0191U to minimize the risk of maternal antibody formation and adverse blood reactions in the newborn.
3. A patient is scheduled for an organ transplant, and CPT 0191U is performed to ensure compatibility and minimize potential blood-type incompatibility reactions.
4. A blood bank analyzes a blood donor’s specimen using CPT 0191U to determine the presence or absence of Indian (IN) blood group antigens for better matching with potential recipients.
5. A clinician orders CPT 0191U for a patient with a known history of adverse reactions to blood transfusions to identify potential Indian (IN) blood group antigens responsible for the reactions.
6. A newborn’s blood sample is sent for CPT 0191U analysis to determine the presence or absence of Indian (IN) blood group antigens and ensure compatibility with maternal blood.
7. A patient with a planned bone marrow transplant undergoes CPT 0191U to assess compatibility and minimize potential blood-type incompatibility reactions.
8. A clinician orders CPT 0191U for a patient with a suspected Indian (IN) blood group antigen deficiency to confirm the diagnosis and guide appropriate treatment.
9. A pregnant woman with a history of adverse blood reactions undergoes CPT 0191U to assess the presence or absence of Indian (IN) blood group antigens and determine the risk of adverse reactions in the current pregnancy.
10. A patient with a known Indian (IN) blood group antigen deficiency undergoes CPT 0191U to monitor the presence or absence of these antigens over time and guide ongoing medical management.