How To Use CPT Code 0196U

CPT 0196U describes the genotyping of red cell antigen (Lutheran blood group) using gene analysis. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0196U.

1. What is CPT Code 0196U?

CPT 0196U can be used to describe the gene analysis of the red cell antigen (Lutheran blood group). This code is specifically used for analyzing exon 3 of the BCAM (basal cell adhesion molecule) gene, which determines the individual’s Lutheran (LU) blood group by identifying the presence or absence of specific red blood cell (RBC) antigens.

2. Official Description

The official description of CPT code 0196U is: ‘Red cell antigen (Lutheran blood group) genotyping (LU), gene analysis, BCAM (basal cell adhesion molecule [Lutheran blood group]) exon 3.’

3. Procedure

1. The lab analyst performs gene analysis using a patient specimen, such as blood or saliva, to analyze exon 3 of the BCAM gene.
2. The analysis involves DNA amplification using techniques like polymerase chain reaction (PCR) and utilizes a Luminex® platform to identify genetic markers for specific red blood cell antigens in the LU blood group.
3. This analysis helps determine the presence or absence of specific RBC antigens, which can aid in minimizing adverse blood-type incompatibility reactions in blood transfusions, organ transplants, or during pregnancy and newborn care.

4. Qualifying circumstances

CPT 0196U is typically ordered for specimens from blood or tissue donors and recipients to improve transfusion or transplant compatibility. It can also be ordered for maternal blood specimens to minimize adverse blood reactions in newborns or maternal antibody formation. This test provides advantages over traditional serology typing methods, as it is not affected by antibody interference, weak antibody reactivity, or antigen expression.

5. When to use CPT code 0196U

CPT code 0196U should be used when there is a need to analyze the red cell antigen (Lutheran blood group) using gene analysis. It is specifically used for analyzing exon 3 of the BCAM gene to determine the individual’s Lutheran (LU) blood group and identify specific RBC antigens.

6. Documentation requirements

To support a claim for CPT 0196U, the following documentation is required:

• Patient’s specimen type (blood or saliva)
• Date of service
• Results of the gene analysis for exon 3 of the BCAM gene
• Identification of specific red blood cell antigens in the LU blood group
• Signature of the lab analyst performing the gene analysis

7. Billing guidelines

When billing for CPT 0196U, ensure that the gene analysis is performed on a patient specimen, such as blood or saliva, and that the analysis specifically targets exon 3 of the BCAM gene. This code should be reported for a single specimen analyzed on a single date of service. It is important to use the correct code for the specific proprietary test provided by the lab, and to report one unit of this code for each test performed.

8. Historical information

CPT code 0196U 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’s blood specimen is analyzed using gene analysis to determine their Lutheran (LU) blood group and identify specific red blood cell antigens.
2. A donor’s blood specimen is tested to ensure compatibility with a recipient for a blood transfusion or organ transplant.
3. A maternal blood specimen is analyzed to minimize adverse blood reactions in a newborn or maternal antibody formation during pregnancy.
4. A patient’s saliva specimen is analyzed to determine their Lutheran (LU) blood group and identify specific red blood cell antigens.
5. A blood specimen from a tissue donor is tested to improve compatibility for an organ transplant.
6. A maternal blood specimen is analyzed to minimize adverse blood reactions in a newborn or maternal antibody formation during pregnancy.
7. A patient’s blood specimen is tested to determine their Lutheran (LU) blood group and identify specific red blood cell antigens for transfusion purposes.
8. A saliva specimen from a tissue recipient is analyzed to ensure compatibility for an organ transplant.
9. A maternal blood specimen is analyzed to minimize adverse blood reactions in a newborn or maternal antibody formation during pregnancy.
10. A patient’s blood specimen is analyzed using gene analysis to determine their Lutheran (LU) blood group and identify specific red blood cell antigens.