How To Use CPT Code 0194U

CPT 0194U describes the gene analysis for the Kell blood group antigen, specifically analyzing exon 8 of the KEL gene. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0194U.

1. What is CPT Code 0194U?

CPT 0194U can be used to report the Navigator KEL Sequencing test from Grifols Immunohematology Center. This test analyzes the gene sequences of the Kell blood group antigen, specifically focusing on exon 8 of the KEL gene. The purpose of this test is to identify the presence or absence of specific red blood cell antigens in the Kell blood group. By determining the individual’s Kell blood group, clinicians can minimize adverse blood-type incompatibility reactions in various medical procedures such as blood transfusions, organ transplants, and pregnancy.

2. Official Description

The official description of CPT code 0194U is: ‘Red cell antigen (Kell blood group) genotyping (KEL), gene analysis, KEL (Kell metallo-endopeptidase [Kell blood group]) exon 8.’

3. Procedure

1. The lab analyst performs gene analysis using a patient specimen, such as blood or saliva.
2. The analysis focuses on exon 8 of the KEL gene, which determines the presence or absence of specific red blood cell antigens in the Kell blood group.
3. The test involves DNA amplification, typically using polymerase chain reaction (PCR), to make multiple copies of the desired gene for study.
4. A Luminex® platform is used to identify genetic markers for specific red blood cell antigens in the Kell blood group.
5. The results of the gene analysis provide information on the individual’s Kell blood group, which can be used to improve transfusion or transplant compatibility or minimize adverse reactions in pregnancy and newborns.

4. Qualifying circumstances

CPT 0194U is typically ordered for patients who require information about their Kell blood group antigens. This information is crucial for ensuring compatibility in transfusions, transplants, and pregnancy. The test can be performed on specimens from blood or tissue donors and recipients, as well as maternal blood to minimize adverse reactions in newborns. Incompatible Kell blood group antigens can lead to severe hemolytic disease of the newborn (HDN). Blood group genotyping offers advantages over traditional serology typing methods, as it is less prone to antibody interference or weak reactivity.

5. When to use CPT code 0194U

CPT code 0194U should be used when the Navigator KEL Sequencing test from Grifols Immunohematology Center is performed to analyze the Kell blood group antigens. This code should only be reported for the specific proprietary test described and should not be used for any other test. It is important to ensure that the test is performed on a single specimen analyzed on a single date of service.

6. Documentation requirements

To support a claim for CPT code 0194U, the following documentation is required:

• Patient’s information and specimen details
• Description of the specific test performed, including the analysis of exon 8 of the KEL gene
• Date of service and the results of the gene analysis
• Indication for ordering the test and its clinical relevance
• Signature of the lab analyst performing the gene analysis

7. Billing guidelines

When billing for CPT code 0194U, ensure that the test is performed by Grifols Immunohematology Center for the Navigator KEL Sequencing test. Report one unit of this code for a single specimen analyzed on a single date of service. Some payers may separately reimburse for specimen collection using a code such as 36415. It is important to use the correct code for the specific blood group antigen genotype analysis, as Grifols Immunohematology Center provides multiple PLA codes for different blood group antigens.

8. Historical information

CPT code 0194U 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 undergoes the Navigator KEL Sequencing test to determine their Kell blood group antigens for compatibility in a planned blood transfusion.
2. A pregnant woman’s blood is tested using CPT code 0194U to assess the compatibility of her Kell blood group antigens with those of her fetus, minimizing the risk of hemolytic disease of the newborn.
3. A tissue donor and recipient both undergo the Navigator KEL Sequencing test to ensure compatibility for an upcoming organ transplant.
4. A newborn’s blood is analyzed using CPT code 0194U to identify their Kell blood group antigens and prevent adverse reactions during blood transfusions.
5. A patient with a history of adverse reactions to previous blood transfusions undergoes the Navigator KEL Sequencing test to identify any incompatible Kell blood group antigens.
6. A physician orders CPT code 0194U to determine the Kell blood group antigens of a potential bone marrow donor and recipient for compatibility in a transplant procedure.
7. A patient with a known Kell blood group antigen deficiency undergoes the Navigator KEL Sequencing test to monitor any changes in their antigen profile.
8. A laboratory performs gene analysis using CPT code 0194U to identify the Kell blood group antigens in a patient’s blood sample for research purposes.
9. A patient with a rare blood type undergoes the Navigator KEL Sequencing test to determine their Kell blood group antigens for potential blood donations.
10. A pregnant woman’s blood is tested using CPT code 0194U to assess the compatibility of her Kell blood group antigens with those of her partner, helping to predict the risk of hemolytic disease of the newborn.