How To Use CPT Code 0202U

CPT 0202U describes a specific laboratory test used to detect and differentiate nucleic acid of SARS-CoV-2, the virus responsible for COVID-19, from other respiratory pathogens. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0202U.

1. What is CPT Code 0202U?

CPT 0202U is a proprietary laboratory analysis (PLA) code that represents a specific test called the BioFire® FilmArray® Respiratory Panel 2.1 (RP2.1) from BioFire® Diagnostics. This test is an automated PCR test performed on a nasopharyngeal swab specimen to detect 22 respiratory pathogens, including SARS-CoV-2, the virus that causes COVID-19. The test provides a qualitative result, indicating whether the pathogen is detected or not detected.

2. Official Description

The official description of CPT code 0202U is: ‘Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected.’

It is important to note that this code is a PLA code and is specific to the BioFire® FilmArray® RP2.1 test. For other similar tests, refer to the appropriate code listing on the AMA CPT website.

3. Procedure

1. The laboratory analyst receives a nasopharyngeal swab specimen in transport media.
2. The specimen is processed using the BioFire® FilmArray® system, an FDA-approved automated multiplex PCR analyzer.
3. The system performs sample preparation, nucleic acid amplification, target detection, analysis, and reporting in a single platform.
4. The test detects and differentiates the nucleic acid of 22 respiratory pathogens, including SARS-CoV-2, from a single specimen.
5. The result is reported as either ‘detected’ or ‘not detected’ for each pathogen.

4. Qualifying circumstances

CPT code 0202U is used for patients with respiratory infection symptoms who require testing to detect and differentiate the nucleic acid of SARS-CoV-2 from other common respiratory viral and bacterial pathogens. The test is performed on a nasopharyngeal swab specimen, and the laboratory must use the BioFire® FilmArray® RP2.1 test specifically to report this code.

5. When to use CPT code 0202U

CPT code 0202U should be used when a clinician orders the BioFire® FilmArray® RP2.1 test for a patient with respiratory infection symptoms. This test is specifically designed to detect and differentiate the nucleic acid of SARS-CoV-2 from other respiratory pathogens. It is important to use this code only for the appropriate proprietary test and report one unit of this code for a single specimen analyzed on a single date of service.

6. Documentation requirements

To support a claim for CPT code 0202U, the documentation should include:

• Indication for the test, such as respiratory infection symptoms
• Specific test performed, BioFire® FilmArray® RP2.1
• Date of service
• Result of the test for each pathogen, reported as ‘detected’ or ‘not detected’

7. Billing guidelines

When billing for CPT code 0202U, ensure that the test performed is the BioFire® FilmArray® RP2.1 and that the result is reported as ‘detected’ or ‘not detected’ for each pathogen. This code should not be reported with any other CPT code for the same test. Some payers may separately reimburse for specimen collection, so it is important to check with the appropriate payer for their specific guidelines.

8. Historical information

CPT code 0202U was added to the Current Procedural Terminology system on May 20, 2020. As of the code’s effective date, there have been no updates or changes to the code.

9. Examples

1. A patient presents with respiratory infection symptoms, and the clinician orders the BioFire® FilmArray® RP2.1 test to detect and differentiate the nucleic acid of SARS-CoV-2 from other respiratory pathogens.
2. A healthcare provider suspects a patient may have COVID-19 and requests the BioFire® FilmArray® RP2.1 test to confirm the presence of SARS-CoV-2.
3. A patient with respiratory symptoms is tested using the BioFire® FilmArray® RP2.1 to identify the specific respiratory pathogen causing their illness.
4. A clinician orders the BioFire® FilmArray® RP2.1 test for a patient with respiratory infection symptoms to rule out the presence of SARS-CoV-2 and other common respiratory pathogens.
5. A laboratory performs the BioFire® FilmArray® RP2.1 test on a nasopharyngeal swab specimen from a patient with respiratory symptoms to determine the presence or absence of SARS-CoV-2.
6. A patient with respiratory infection symptoms undergoes testing with the BioFire® FilmArray® RP2.1 to identify the specific respiratory pathogen causing their illness and guide appropriate treatment.
7. A clinician orders the BioFire® FilmArray® RP2.1 test for a patient with suspected COVID-19 to confirm the presence of SARS-CoV-2 and rule out other respiratory pathogens.
8. A laboratory performs the BioFire® FilmArray® RP2.1 test on a nasopharyngeal swab specimen from a patient with respiratory symptoms to detect and differentiate the nucleic acid of SARS-CoV-2 from other respiratory pathogens.
9. A patient with respiratory infection symptoms is tested using the BioFire® FilmArray® RP2.1 to identify the specific respiratory pathogen causing their illness and inform infection control measures.
10. A healthcare provider orders the BioFire® FilmArray® RP2.1 test for a patient with respiratory symptoms to determine the presence or absence of SARS-CoV-2 and guide appropriate management.