How To Use CPT Code 0351U

CPT 0351U describes a proprietary laboratory analysis (PLA) test that evaluates a serum specimen for levels of specific immune-response biomarkers. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0351U?

CPT 0351U is a unique laboratory test that analyzes a serum specimen to determine the likelihood of a bacterial infection. This test measures the levels of three immune-response biomarkers: tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein-10 (IP-10), and C-reactive protein (CRP). By performing an algorithmic analysis of these biomarker levels, the test provides a score indicating the probability of a bacterial infection.

2. Official Description

The official description of CPT code 0351U is: ‘Infectious disease (bacterial or viral), biochemical assays, tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein-10 (IP-10), and C-reactive protein, serum, algorithm reported as likelihood of bacterial infection.’

3. Procedure

1. The analyst inserts a serum specimen into the MeMed BV® analyzer.
2. The analyzer performs rapid multiplex protein measurement of the three immune-response biomarkers: TRAIL, IP-10, and CRP.
3. An algorithmic analysis is conducted using the biomarker levels to determine the likelihood of a bacterial infection.
4. A report is generated, providing a score indicating the probability of a bacterial infection.

4. Qualifying circumstances

CPT 0351U is specific to the MeMed BV® test from MeMed Diagnostics Ltd. It should only be reported for this particular test, as it is a proprietary laboratory analysis (PLA) code. The test evaluates serum specimens for the levels of TRAIL, IP-10, and CRP, and provides a score indicating the likelihood of a bacterial infection.

5. When to use CPT code 0351U

CPT code 0351U should be used when a clinician needs to determine the likelihood of a bacterial infection in a patient. This test is particularly useful in distinguishing between bacterial and viral infections, helping clinicians make informed decisions about antibiotic prescriptions. It is important to note that CPT code 0351U should only be used for the MeMed BV® test and not for any other similar tests.

6. Documentation requirements

To support a claim for CPT code 0351U, the following documentation is required:

• Identification of the MeMed BV® test as the specific test performed
• Date of service
• Results of the algorithmic analysis, including the score indicating the likelihood of a bacterial infection
• Signature of the clinician

7. Billing guidelines

When billing for CPT code 0351U, it is important to ensure that the MeMed BV® test was performed. This code should not be reported for any other similar tests. Additionally, it is advisable to check with individual payers regarding their specific requirements for billing this test. Some payers may also separately reimburse for specimen collection.

8. Historical information

CPT code 0351U was added to the Current Procedural Terminology system on October 1, 2022. As a relatively new code, there have been no updates or changes since its addition.

9. Examples

1. A clinician uses CPT code 0351U to determine the likelihood of a bacterial infection in a patient presenting with symptoms of an upper respiratory tract infection.
2. A patient with a suspected urinary tract infection undergoes the MeMed BV® test, and CPT code 0351U is reported to assess the probability of a bacterial infection.
3. A clinician orders the MeMed BV® test for a patient with a skin infection to aid in the diagnosis and treatment decision-making process.
4. CPT code 0351U is used to evaluate the likelihood of a bacterial infection in a patient with symptoms of a gastrointestinal illness.
5. A clinician utilizes the MeMed BV® test and reports CPT code 0351U to assess the probability of a bacterial infection in a patient with a suspected lower respiratory tract infection.
6. A patient with a suspected bloodstream infection undergoes the MeMed BV® test, and CPT code 0351U is reported to aid in the diagnosis and management of the infection.
7. CPT code 0351U is used to evaluate the likelihood of a bacterial infection in a patient with symptoms of a central nervous system infection.
8. A clinician orders the MeMed BV® test for a patient with a suspected bone or joint infection, reporting CPT code 0351U to assist in the diagnostic process.
9. A patient with symptoms of a soft tissue infection undergoes the MeMed BV® test, and CPT code 0351U is reported to assess the probability of a bacterial infection.
10. CPT code 0351U is used to evaluate the likelihood of a bacterial infection in a patient with symptoms of a systemic infection.