Summary & Overview
CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic
CPT code 0010U designates a Proprietary Laboratory Analyses (PLA) test: Bacterial Typing by Whole Genome Sequencing developed by Mayo Clinic. This genomic sequencing assay characterizes multiple identified bacterial cultures to determine genetic type and report the degree of relatedness, supporting epidemiologic investigations, infection control, and outbreak detection. Nationally, PLA codes like 0010U matter because they identify laboratory tests that are unique to a single manufacturer or laboratory, affecting coverage, pricing, and clinical adoption for advanced molecular diagnostics.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical purpose and service setting, an explanation of how the PLA designation shapes coding and billing, and what to expect in payer coverage considerations. The publication summarizes common modifier usage, typical sites of service, and places the test in clinical context for infection prevention and public health microbiology. It also outlines where input data were available and notes items marked as "Data not available in the input." The content is intended for billing managers, laboratory directors, and policy analysts seeking a national-level briefing on CPT code 0010U and its role in genomic bacterial typing.
Billing Code Overview
CPT code 0010U is a Proprietary Laboratory Analyses (PLA) code that describes Bacterial Typing by Whole Genome Sequencing by Mayo Clinic. The code covers a genomic sequencing service performed on multiple identified bacterial cultures to determine genetic type and report degree of relatedness among isolates.
Service type: Genomic sequencing for bacterial typing (clinical laboratory service)
Typical site of service: Clinical reference laboratory or specialized molecular microbiology laboratory
Clinical & Coding Specifications
Clinical Context
A hospitalized patient in a tertiary care center develops multiple bacterial infections from different culture sites during a suspected nosocomial outbreak. The patient is a 68-year-old with recent surgery who has positive cultures for the same bacterial species from a surgical wound, blood, and urine. Infection control and the clinical microbiology team request bacterial typing by whole genome sequencing to determine whether isolates are genetically related and to guide outbreak investigation. Specimens (identified bacterial cultures) are submitted from the hospital microbiology lab to the Mayo Clinic reference laboratory. The laboratory performs whole genome sequencing on each isolate, analyzes single nucleotide polymorphism (SNP) differences, assigns sequence types, and generates a report of genetic relatedness for infection prevention, epidemiology, and treating clinicians. Typical workflow steps include: ordering the PLA test on the microbiology panel, obtaining transport of cultured isolates, accessioning and sequencing at the reference lab, bioinformatic analysis, and distribution of the final report to the infection control team and ordering clinician. Typical site of service is a hospital laboratory or reference laboratory; ordering originates from inpatient wards, intensive care units, or the infection prevention office.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
TC | Technical component | Use when billing only the laboratory technical component (sequencing, bioinformatics) without professional interpretation billed separately |
26 | Professional component | Use when billing only the professional component (interpretation and report) separate from the lab technical work |
59 | Data not available in the input. | Data not available in the input. |
62 | Two surgeons | Rarely applicable; use if two qualified laboratorians or pathologists share distinct portions of professional work (institutional policy-dependent) |
78 | Return to operating/procedure room after intraoperative complication | Not applicable clinically to this lab test except in institutional billing workflows for combined services |
80 | Assistant surgeon | Not typically used for laboratory PLA codes; included for institutional policy reference |
QK | Medical direction of two or more providers | Use if one pathologist medically directs multiple assistants in interpretation services |
QX | Modifiers for assistant at surgery | Not typically applicable; included for completeness when assistant billing conventions exist |
QY | Medical supervision by physician: more than four concurrent procedures | Rarely applicable; use only if supervision rules are met per payer policy |
22 | Increased procedural services | Use when documentation supports substantially greater lab effort or complexity (rare for standardized PLA sequencing) |
52 | Reduced services | Use when a reduced or partial sequencing service is performed and documented |
53 | Discontinued procedure | Use if sequencing was initiated but discontinued for documented clinical reasons |
AD | Pathology code: Physician assisting at surgery | Sometimes used in pathology/workflow contexts per payer rules; not routine for PLA codes |
QY | Data not available in the input. | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RH0000X | Infectious Disease | Clinicians who order and interpret implications for patient management and infection control |
| 207K00000X | Clinical Pathology | Pathologists who oversee laboratory testing, interpretation, and reporting of genomic analyses |
| 207LP2900X | Clinical Laboratory | Clinical laboratory directors and technologists who perform sequencing and technical workflows |
| 207L00000X | Medical Microbiology | Specialists in microbiology who select isolates, perform culture-based workup, and coordinate with reference lab |
| 208D00000X | Public Health | Infection preventionists and public health laboratorians who use results for outbreak investigation |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
A41.9 | Sepsis, unspecified organism | Sepsis with positive cultures may prompt typing to assess relatedness between isolates in a patient or cluster |
T81.4XXA | Infection following a procedure, initial encounter | Postoperative infections where multiple isolates suggest a potential outbreak source |
Z11.59 | Encounter for screening for other bacterial diseases | Public health screening contexts when typing is used for surveillance and epidemiology |
A49.9 | Bacterial infection, unspecified | General bacterial infections when isolate typing informs management or epidemiology |
R78.81 | Bacteremia | Presence of bacteria in blood that require isolate comparison across sites or patients for outbreak control |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0010U | Bacterial typing by whole genome sequencing (Mayo Clinic) | Primary PLA code describing whole genome sequencing and related analysis for multiple bacterial isolates to determine genetic relatedness |
87110 | Culture, bacterial, any source, except blood, aerobic, colony count not included | Performed prior to sequencing to obtain isolates; cultures establish growth and identification |
87040 | Culture, bacterial; blood, aerobic and anaerobic | Blood cultures may yield isolates that are subsequently submitted for WGS typing |
87177 | Identification by DNA probe, each organism | Supplemental molecular identification sometimes used before or alongside sequencing |
87999 | Unlisted microbiology procedure | Used rarely for other non-standard molecular tests when no specific PLA exists; administrative alternative in complex workflows |
88291 | Microbial genotyping, infectious agent, amplified probe, each organism | Other molecular genotyping methods that may be performed instead of or prior to WGS for typing |
Note: If payor-specific bundling or PLA handling policies apply, coding and claim adjudication may vary by payer (Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, Medicare).