How To Use CPT Code 0353U

CPT 0353U describes a specific proprietary laboratory analysis (PLA) test for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae, two common sexually transmitted infections (STIs). This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0353U.

1. What is CPT Code 0353U?

CPT 0353U is a unique code that represents a proprietary laboratory analysis (PLA) test called Xpert® CT/NG from Cepheid®. This test is used to detect Chlamydia trachomatis and Neisseria gonorrhoeae, which are bacteria responsible for causing common sexually transmitted infections (STIs). It is performed on various specimens, including urine, vaginal, pharyngeal, or rectal samples.

2. Official Description

The official description of CPT code 0353U is: ‘Infectious agent detection by nucleic acid (DNA), Chlamydia trachomatis and Neisseria gonorrhoeae, multiplex amplified probe technique, urine, vaginal, pharyngeal, or rectal, each pathogen reported as detected or not detected.’

3. Procedure

1. The Xpert® CT/NG test is performed using a multiplex amplified probe technique.
2. A specimen, such as urine, vaginal, pharyngeal, or rectal sample, is collected from the patient.
3. The specimen is transferred to the sample chamber of the Xpert® CT/NG cartridge.
4. The cartridge is processed on Cepheid’s GeneXpert instrument, which automates the DNA extraction, polymerase chain reaction (PCR) amplification, and detection of the bacterial targets.
5. An algorithmic analysis is performed to determine whether Chlamydia trachomatis and Neisseria gonorrhoeae are detected or not detected in the specimen.
6. The test can provide results within 90 minutes.

4. Qualifying circumstances

CPT code 0353U is used for patients who exhibit symptoms of a sexually transmitted infection (STI) or for those who are at risk of infection. It is important to note that this code applies specifically to the Xpert® CT/NG test from Cepheid®. Other specific infectious agent detection codes should not be reported in addition to CPT code 0353U.

5. When to use CPT code 0353U

CPT code 0353U should be used when the Xpert® CT/NG test is performed to detect Chlamydia trachomatis and Neisseria gonorrhoeae in urine, vaginal, pharyngeal, or rectal specimens. It is appropriate for patients who present with symptoms of an STI or for those who require routine screening, as recommended by the Centers for Disease Control and Prevention (CDC).

6. Documentation requirements

To support a claim for CPT code 0353U, the following documentation is necessary:

• Indication of the patient’s symptoms or risk factors for an STI
• Type of specimen collected (urine, vaginal, pharyngeal, or rectal)
• Date of the test
• Results of the test (whether Chlamydia trachomatis and Neisseria gonorrhoeae were detected or not detected)
• Signature of the laboratory analyst performing the test

7. Billing guidelines

When billing for CPT code 0353U, ensure that the Xpert® CT/NG test from Cepheid® is performed. Report one unit of this code for each specimen analyzed on a single date of service. Do not report other specific infectious agent detection codes in addition to CPT code 0353U. Follow the guidelines provided by the payer for proper reimbursement.

8. Historical information

CPT code 0353U 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 patient presents with symptoms of an STI and provides a urine sample for the Xpert® CT/NG test. The test results indicate the detection of Chlamydia trachomatis but not Neisseria gonorrhoeae.
2. A healthcare provider performs the Xpert® CT/NG test on a patient who is at risk of an STI and provides a vaginal sample. The test results show the detection of both Chlamydia trachomatis and Neisseria gonorrhoeae.
3. A patient undergoes routine screening for STIs and provides a pharyngeal sample for the Xpert® CT/NG test. The test results indicate the detection of Neisseria gonorrhoeae but not Chlamydia trachomatis.
4. A patient with symptoms of an STI provides a rectal sample for the Xpert® CT/NG test. The test results show the detection of both Chlamydia trachomatis and Neisseria gonorrhoeae.
5. A healthcare provider performs the Xpert® CT/NG test on a patient with no symptoms but who is at risk of an STI. The patient provides a urine sample, and the test results indicate the detection of Chlamydia trachomatis but not Neisseria gonorrhoeae.
6. A patient undergoes routine screening for STIs and provides a vaginal sample for the Xpert® CT/NG test. The test results show the detection of both Chlamydia trachomatis and Neisseria gonorrhoeae.
7. A patient presents with symptoms of an STI and provides a pharyngeal sample for the Xpert® CT/NG test. The test results indicate the detection of Neisseria gonorrhoeae but not Chlamydia trachomatis.
8. A healthcare provider performs the Xpert® CT/NG test on a patient who is at risk of an STI and provides a rectal sample. The test results show the detection of both Chlamydia trachomatis and Neisseria gonorrhoeae.
9. A patient undergoes routine screening for STIs and provides a urine sample for the Xpert® CT/NG test. The test results indicate the detection of Chlamydia trachomatis but not Neisseria gonorrhoeae.
10. A patient with symptoms of an STI provides a vaginal sample for the Xpert® CT/NG test. The test results show the detection of both Chlamydia trachomatis and Neisseria gonorrhoeae.