How To Use CPT Code 0195U

CPT 0195U describes a targeted sequencing test called KLF1 (Kruppel-like factor 1). This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0195U.

1. What is CPT Code 0195U?

CPT 0195U is a proprietary laboratory analysis (PLA) code that represents the Navigator KLF1 Sequencing test. This test is performed by Grifols Immunohematology Center and is used to analyze exon 13 of the KLF1 gene. The analysis helps identify Lutheran (LU) blood group antigens, which are important for minimizing adverse blood-type incompatibility reactions in blood transfusions, organ transplants, and during pregnancy and newborn care.

2. Official Description

The official description of CPT code 0195U is: ‘KLF1 (Kruppel-like factor 1), targeted sequencing (i.e., exon 13).’ This code specifically refers to the targeted sequencing of exon 13 of the KLF1 gene to identify Lutheran (LU) blood group antigens.

3. Procedure

1. The laboratory analyst performs targeted sequencing using a patient specimen, such as blood or saliva.
2. The targeted sequencing focuses on exon 13 of the KLF1 gene.
3. DNA amplification is performed using a method like polymerase chain reaction (PCR).
4. A Luminex® platform is utilized to identify genetic markers for specific red blood cell antigens in the Lutheran blood group.
5. The analysis helps determine the presence or absence of specific red blood cell antigens, which are crucial for blood transfusion and transplant compatibility, as well as in pregnancy and newborn care.

4. Qualifying circumstances

CPT code 0195U is used when clinicians require information about Lutheran (LU) blood group antigens for transfusion or transplant compatibility, or to minimize adverse blood reactions in pregnancy and newborns. The test analyzes exon 13 of the KLF1 gene, which impacts the expression of the BCAM gene responsible for determining the Lutheran blood group.

5. When to use CPT code 0195U

CPT code 0195U should be used when clinicians need to analyze exon 13 of the KLF1 gene to identify Lutheran (LU) blood group antigens. This test is particularly beneficial when traditional serology typing methods may be compromised by antibody interference, weak antibody reactivity, or antigen expression.

6. Documentation requirements

To support a claim for CPT code 0195U, the following documentation is required:

• Patient information and specimen source (blood or saliva)
• Date of service and analysis
• Details of the targeted sequencing procedure
• Results of the analysis, including the presence or absence of specific red blood cell antigens
• Signature of the laboratory analyst performing the test

7. Billing guidelines

When billing for CPT code 0195U, ensure that the test is performed by Grifols Immunohematology Center and that the Navigator KLF1 Sequencing test is specifically requested. Report one unit of this code for each individual specimen analyzed on a single date of service. It is important to note that some payers may separately reimburse for specimen collection using a code such as 36415. Additionally, make sure to use the correct code for the specific blood group antigen analysis required.

8. Historical information

CPT code 0195U was added to the Current Procedural Terminology system on July 1, 2020. As of now, there have been no updates or changes to this code.

9. Examples

1. A clinician orders CPT code 0195U to analyze exon 13 of the KLF1 gene in a blood sample from a patient who requires a blood transfusion.
2. A laboratory performs the Navigator KLF1 Sequencing test using CPT code 0195U on a saliva specimen from a tissue donor to ensure compatibility with a recipient for an organ transplant.
3. A clinician requests CPT code 0195U to analyze exon 13 of the KLF1 gene in a blood sample from a pregnant patient to minimize adverse blood reactions in the newborn.
4. A laboratory utilizes CPT code 0195U to perform targeted sequencing of exon 13 of the KLF1 gene in a blood sample from a patient with a history of adverse blood transfusion reactions.
5. A clinician orders CPT code 0195U to analyze exon 13 of the KLF1 gene in a blood sample from a patient with a known blood group antibody to determine the presence or absence of specific red blood cell antigens.
6. A laboratory performs the Navigator KLF1 Sequencing test using CPT code 0195U on a saliva specimen from a tissue recipient to ensure compatibility with a donor for an organ transplant.
7. A clinician requests CPT code 0195U to analyze exon 13 of the KLF1 gene in a blood sample from a pregnant patient with a history of adverse blood reactions in previous pregnancies.
8. A laboratory utilizes CPT code 0195U to perform targeted sequencing of exon 13 of the KLF1 gene in a blood sample from a patient with a suspected blood group antigen discrepancy.
9. A clinician orders CPT code 0195U to analyze exon 13 of the KLF1 gene in a blood sample from a patient with a known blood group antibody to determine the compatibility for a potential blood transfusion.
10. A laboratory performs the Navigator KLF1 Sequencing test using CPT code 0195U on a saliva specimen from a tissue donor to ensure compatibility with a recipient for a bone marrow transplant.