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CPT 0025U: Tenofovir Quantitation in Urine via LC–MS/MS

CPT code 0025U denotes a Proprietary Laboratory Analyses (PLA) test: the Synergy Medical Laboratories (UrSur, Inc.) tenofovir quantitation in urine performed with liquid chromatography–tandem mass spectrometry (LC–MS/MS). This PLA code identifies a single, manufacturer- or laboratory-specific diagnostic assay used to measure tenofovir exposure, relevant to medication monitoring, adherence assessment, and pharmacokinetic evaluation. Nationally, PLA codes like 0025U matter because they enable unique identification and tracking of proprietary assays, support laboratory billing clarity, and can affect coverage and utilization patterns across payers.

Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code's clinical purpose and testing modality, typical sites of service, and payers considered in the coverage landscape. The publication summarizes available benchmarking and coverage context where present, notes common billing modifiers associated with laboratory services, and outlines what information is and is not available in the source data. The content is intended to inform billing, coding, and policy stakeholders about the nature of this PLA code, its clinical relevance, and the national payer context without offering clinical recommendations.

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Billing Code Overview

CPT code 0025U is a Proprietary Laboratory Analyses (PLA) code that describes a single, manufacturer- or lab-specific test: the Synergy Medical Laboratories (UrSur, Inc.) tenofovir quantitation assay. The test measures tenofovir levels in urine using liquid chromatography with tandem mass spectrometry (LC–MS/MS).

Service type: Proprietary laboratory pharmacologic quantitation (urine tenofovir measurement) using LC–MS/MS
Typical site of service: Clinical laboratory or specialized reference laboratory performing LC–MS/MS urine assays

Data not available in the input.

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CPT 0025U: Tenofovir Quantitation in Urine via LC–MS/MS

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Billing Code Overview

Service type: Proprietary laboratory pharmacologic quantitation (urine tenofovir measurement) using LC–MS/MS
Typical site of service: Clinical laboratory or specialized reference laboratory performing LC–MS/MS urine assays

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A patient receiving antiretroviral therapy for HIV or hepatitis B presents for routine monitoring or suspected nonadherence or potential drug toxicity. The clinician orders a urine tenofovir quantitation by liquid chromatography–tandem mass spectrometry to assess recent tenofovir exposure and adherence, evaluate drug accumulation in renal impairment, or investigate a possible adverse effect. A typical workflow: the outpatient clinic or infusion center collects a random or timed urine specimen, labels and ships the specimen to Synergy Medical Laboratories (UrSur, Inc.) with test requisition information and relevant clinical history; the reference lab performs LC–MS/MS tenofovir quantitation and returns a numeric concentration with interpretive comments to the ordering provider; the clinician reviews results in the electronic health record and documents adherence counseling, dose adjustments, or further renal evaluation as indicated. Typical sites of service include outpatient clinics, specialty infectious disease or hepatology clinics, ambulatory infusion centers, and reference laboratory facilities.

Coding Specifications

Modifier	Description	When to Use
`00`	Not a valid modifier for Medicare billing (historical)	Rarely used; generally not applied to PLA testing
`11`	Office or outpatient E/M (standard)	Attach when billing in conjunction with unrelated office visits as appropriate per payer rules
`26`	Professional component	Use when billing only the professional interpretation component separate from the technical lab work
`TC`	Technical component	Use when billing only the technical component (laboratory processing) of the test
`52`	Reduced services	Use if a specimen or step in the test was partially performed reducing the service
`53`	Discontinued procedure	Use when the specimen collection or analytic process was begun but discontinued for specific clinical reasons
`59`	Distinct procedural service	Note: `59` is not in the provided list; therefore not included per strict rules
`QX`	Ordering/servicing laboratory modifier — CLIA waived/point-of-care distinction	Use when applicable to designate the appropriate laboratory relationship per payer rules
`QY`	Ordering/performing laboratory of service	Use to indicate the performing laboratory meets requirements to bill for testing
`AD`	Physician assistant, certified nurse midwife, etc.	Use when the billing practitioner is a physician assistant or others covered by `AD` per payer guidance
`AS`	Physician assistant in surgery	Use only when applicable for procedural oversight; rarely relevant to laboratory testing
`QK`	Medical direction of two, three, or four ancillary personnel	Use when documenting medical direction of lab personnel for complex testing
`QY`	Ordering/performing laboratory of service	Use to indicate the performing laboratory meets requirements to bill for testing

Taxonomy Code	Specialty	Notes
207RH0000X	Infectious Disease	Specialists order and interpret tenofovir levels for HIV management and adherence assessment
207RG0100X	Hepatology	Clinicians managing chronic hepatitis B may order tenofovir monitoring for therapy adherence and toxicity
208D00000X	Clinical Pathology	Laboratory medicine providers oversee LC–MS/MS assay performance and interpretation
208000000X	Internal Medicine	Primary care and HIV-focused internists commonly order medication monitoring tests
363LA2200X	Clinical Laboratory Technologist/Technician	Personnel performing specimen processing and LC–MS/MS testing

Note: The modifier selection above focuses on the most clinically applicable modifiers for a reference laboratory PLA test; exact modifier use depends on payer policies and the billing scenario.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`B20`	Human immunodeficiency virus [HIV] disease	Tenofovir is a core antiretroviral; urine quantitation assesses adherence and exposure
`B18.1`	Chronic viral hepatitis B without delta-agent	Tenofovir is used for hepatitis B therapy; monitoring can assess adherence and toxicity risk
`N18.9`	Chronic kidney disease, unspecified	Renal impairment affects tenofovir clearance; levels guide toxicity risk assessment
`Z79.899`	Other long term (current) drug therapy	Documents ongoing antiretroviral therapy where monitoring of drug levels is relevant
`R53.81`	Other malaise	Nonspecific symptom prompting evaluation including drug toxicity assessment

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81002`	Urinalysis, by dipstick or tablet reagent; non-automated, without microscopy	Often performed at point of care prior to sending urine for tenofovir quantitation to assess specimen quality
`36415`	Collection of venous blood by venipuncture	May be performed concurrently if serum testing (e.g., creatinine) is needed to evaluate renal function when interpreting tenofovir levels
`82570`	Drug assay, qualitative or semiquantitative, multiple drug classes; urine	May be used when broader urine drug screening is ordered in addition to specific tenofovir quantitation
`80053`	Comprehensive metabolic panel	Includes serum creatinine and electrolytes used to assess renal function relevant to tenofovir dosing and toxicity evaluation
`0042U`	Tenofovir alafenamide quantitation, plasma or urine, LC–MS/MS (example PLA)	Other PLA drug quantitation codes for antiretroviral therapeutic drug monitoring; used in parallel when alternate formulations or matrices are tested

CPT 0001U: PreciseType HEA Multiplex Erythrocyte Antigen Assay

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: Urine Metabolomic Polyp Risk Assay (PolypDX™)

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa™ (OVA1 Next Generation) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) Urine Gene Expression Risk Test

CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

CPT 0007U: ToxProtect Urine Drug Screen with DNA Authentication

CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

CPT 0008U: H. pylori Antibiotic Resistance Panel, Gene Sequence Analysis

CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

CPT 0011U: Cordant CORE™ Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcript Testing

Showing 1–10 of 536

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	Not a valid modifier for Medicare billing (historical)	Rarely used; generally not applied to PLA testing
`11`	Office or outpatient E/M (standard)	Attach when billing in conjunction with unrelated office visits as appropriate per payer rules
`26`	Professional component	Use when billing only the professional interpretation component separate from the technical lab work
`TC`	Technical component	Use when billing only the technical component (laboratory processing) of the test
`52`	Reduced services	Use if a specimen or step in the test was partially performed reducing the service
`53`	Discontinued procedure	Use when the specimen collection or analytic process was begun but discontinued for specific clinical reasons
`59`	Distinct procedural service	Note: `59` is not in the provided list; therefore not included per strict rules
`QX`	Ordering/servicing laboratory modifier — CLIA waived/point-of-care distinction	Use when applicable to designate the appropriate laboratory relationship per payer rules
`QY`	Ordering/performing laboratory of service	Use to indicate the performing laboratory meets requirements to bill for testing
`AD`	Physician assistant, certified nurse midwife, etc.	Use when the billing practitioner is a physician assistant or others covered by `AD` per payer guidance
`AS`	Physician assistant in surgery	Use only when applicable for procedural oversight; rarely relevant to laboratory testing
`QK`	Medical direction of two, three, or four ancillary personnel	Use when documenting medical direction of lab personnel for complex testing
`QY`	Ordering/performing laboratory of service	Use to indicate the performing laboratory meets requirements to bill for testing

Taxonomy Code	Specialty	Notes
207RH0000X	Infectious Disease	Specialists order and interpret tenofovir levels for HIV management and adherence assessment
207RG0100X	Hepatology	Clinicians managing chronic hepatitis B may order tenofovir monitoring for therapy adherence and toxicity
208D00000X	Clinical Pathology	Laboratory medicine providers oversee LC–MS/MS assay performance and interpretation
208000000X	Internal Medicine	Primary care and HIV-focused internists commonly order medication monitoring tests
363LA2200X	Clinical Laboratory Technologist/Technician	Personnel performing specimen processing and LC–MS/MS testing

Note: The modifier selection above focuses on the most clinically applicable modifiers for a reference laboratory PLA test; exact modifier use depends on payer policies and the billing scenario.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`B20`	Human immunodeficiency virus [HIV] disease	Tenofovir is a core antiretroviral; urine quantitation assesses adherence and exposure
`B18.1`	Chronic viral hepatitis B without delta-agent	Tenofovir is used for hepatitis B therapy; monitoring can assess adherence and toxicity risk
`N18.9`	Chronic kidney disease, unspecified	Renal impairment affects tenofovir clearance; levels guide toxicity risk assessment
`Z79.899`	Other long term (current) drug therapy	Documents ongoing antiretroviral therapy where monitoring of drug levels is relevant
`R53.81`	Other malaise	Nonspecific symptom prompting evaluation including drug toxicity assessment

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81002`	Urinalysis, by dipstick or tablet reagent; non-automated, without microscopy	Often performed at point of care prior to sending urine for tenofovir quantitation to assess specimen quality
`36415`	Collection of venous blood by venipuncture	May be performed concurrently if serum testing (e.g., creatinine) is needed to evaluate renal function when interpreting tenofovir levels
`82570`	Drug assay, qualitative or semiquantitative, multiple drug classes; urine	May be used when broader urine drug screening is ordered in addition to specific tenofovir quantitation
`80053`	Comprehensive metabolic panel	Includes serum creatinine and electrolytes used to assess renal function relevant to tenofovir dosing and toxicity evaluation
`0042U`	Tenofovir alafenamide quantitation, plasma or urine, LC–MS/MS (example PLA)	Other PLA drug quantitation codes for antiretroviral therapeutic drug monitoring; used in parallel when alternate formulations or matrices are tested

CPT 0001U: PreciseType HEA Multiplex Erythrocyte Antigen Assay

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: Urine Metabolomic Polyp Risk Assay (PolypDX™)

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa™ (OVA1 Next Generation) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) Urine Gene Expression Risk Test

CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

CPT 0007U: ToxProtect Urine Drug Screen with DNA Authentication

CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

CPT 0008U: H. pylori Antibiotic Resistance Panel, Gene Sequence Analysis

CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

CPT 0011U: Cordant CORE™ Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcript Testing

Showing 1–10 of 536

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 0025U: Tenofovir Quantitation in Urine via LC–MS/MS

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Billing Code Overview

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CPT 0025U: Tenofovir Quantitation in Urine via LC–MS/MS

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References