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CPT 0041U: Lyme ImmunoBlot IgM (IGeneX)

CPT code 0041U designates the proprietary Lyme ImmunoBlot IgM assay produced by IGeneX Inc., a laboratory serology test that detects IgM antibodies to five recombinant protein groups for identification of Borrelia burgdorferi, the causative agent of Lyme disease. As a PLA code, 0041U is unique to a single manufacturer and lab and is used where clinicians and payers need a specific identifier for this proprietary assay. Nationally, PLA codes like 0041U matter because they enable tracking, billing, and policy decisions for tests that do not have generic CPT equivalents.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the clinical context for the assay, expected sites of service (clinical laboratories and independent diagnostic testing facilities), and which payers are addressed. The publication outlines benchmarks and payment considerations where available, clarifies coding and billing implications of using a PLA code, and situates the assay within laboratory diagnostic workflows for suspected Lyme disease. Data not available in the input is identified where applicable.

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Billing Code Overview

CPT code 0041U is a Proprietary Laboratory Analyses (PLA) code describing the Lyme ImmunoBlot IgM test from IGeneX Inc. The test detects IgM antibodies to five recombinant protein groups to identify Borrelia burgdorferi, the tick-borne bacterium that causes Lyme disease.

Service type: Laboratory / Infectious disease serology

Typical site of service: Clinical laboratory or independent diagnostic testing facility (IDTF)

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CPT 0041U: Lyme ImmunoBlot IgM (IGeneX)

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Get alerted when payer policies referencing 0041U are released or updated.

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Billing Code Overview

Service type: Laboratory / Infectious disease serology

Typical site of service: Clinical laboratory or independent diagnostic testing facility (IDTF)

Clinical & Coding Specifications

Clinical Context

A 34-year-old patient presents to an outpatient infectious disease clinic with a recent history of a tick bite and a 2-week history of fever, fatigue, headache, and an expanding erythematous skin lesion. The clinician documents concern for early Lyme disease and orders serologic testing to evaluate for acute infection. The specimen is collected by phlebotomy at the clinic and sent to IGeneX, Inc. for proprietary testing. The laboratory performs the Lyme ImmunoBlot IgM (0041U) to detect IgM antibodies against five recombinant Borrelia burgdorferi protein groups. Results are reported to the ordering provider electronically; interpretation includes band reactivity and an IgM positivity assessment. Typical workflow steps: order placed in the electronic health record, specimen drawn and accessioned, couriered to the reference lab, test performed by IGeneX, result finalized and routed back to the clinician, and follow-up plan documented in the outpatient visit note.

Coding Specifications

Modifier	Description	When to Use
`00`	HCPCS/CPT unmodified	Use when no modifier applies to the laboratory service
`11`	Office/Outpatient	Use to indicate the service was provided in the office/outpatient setting when required by payer policy
`26`	Professional component	Use if reporting only the professional component of a test when the supplier separates professional and technical components
`52`	Reduced services	Use if the test was partially performed or specimen inadequacy led to a limited performance documented in the record
`53`	Discontinued procedure	Use when testing was started but discontinued and documentation supports discontinuation
`59`	Distinct procedural service	Data not available in the input.
`62`	Two surgeons	Use when two independent practitioners shared significant, documented portions of a testing-related procedure (rare for lab testing)
`78`	Return to operating room	Use where applicable for operative cases requiring re-entry (not typical for this lab test)
`80`	Assistant at surgery	Use when an assistant is involved in a related surgical procedure (not typical for this lab test)
`AD`	Medical supervision by a physician: more than four concurrent anesthesia procedures	Use per payer rules when anesthesia supervision applies to specimen collection in special settings

Taxonomy Code	Specialty	Notes
`207RH0000X`	Infectious Disease	Specialists who commonly order confirmatory Lyme testing
`207RC0000X`	Internal Medicine	Primary care physicians who evaluate tick-borne illness
`208000000X`	Family Medicine	Clinicians in outpatient settings who collect specimens and order testing
`171M00000X`	Pathology & Laboratory Medicine	Laboratory directors or pathologists overseeing testing and reporting
`363LF0000X`	Phlebotomy/Specimen Collection	Personnel who perform specimen collection and handling

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`A69.20`	Lyme disease, unspecified	Directly indicates Lyme disease testing and is commonly used when serologic confirmation is sought
`A69.21`	Meningitis due to Lyme disease	Neurologic manifestations prompting serologic testing including IgM immunoblot
`A69.23`	Lyme arthritis	Joint symptoms that often trigger confirmatory Borrelia antibody testing
`R50.9`	Fever, unspecified	Nonspecific systemic symptom that may prompt evaluation for tick-borne infections including Lyme disease
`R53.83`	Other fatigue	Common symptom in early or disseminated Lyme disease leading to serologic evaluation
`L90.5`	Erythema chronicum migrans	Classic skin lesion of early Lyme disease that often prompts immediate serologic testing and clinical evaluation

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Commonly performed immediately before `0041U` to obtain the serum sample sent to IGeneX
`99000`	Handling and/or conveyance of specimen for transfer from the physician to a lab (when billable)	May apply when billing for specimen transportation or handling per payer policy
`80061`	Lipid panel (total, HDL, triglycerides)	Example of other laboratory tests that may be ordered at the same visit; not specific to Lyme testing
`86318`	Immunoassay for infectious agent antibody, qualitative or semiquantitative, multiple-step method; each additional step	Represents immunoassay methods commonly used in serologic testing workflows alongside specialized immunoblots
`87070`	Culture, bacterial; any source, aerobic, routine, with isolation and presumptive identification of isolates	May be ordered in differential diagnostic evaluation if other infections are considered

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 Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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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`	HCPCS/CPT unmodified	Use when no modifier applies to the laboratory service
`11`	Office/Outpatient	Use to indicate the service was provided in the office/outpatient setting when required by payer policy
`26`	Professional component	Use if reporting only the professional component of a test when the supplier separates professional and technical components
`52`	Reduced services	Use if the test was partially performed or specimen inadequacy led to a limited performance documented in the record
`53`	Discontinued procedure	Use when testing was started but discontinued and documentation supports discontinuation
`59`	Distinct procedural service	Data not available in the input.
`62`	Two surgeons	Use when two independent practitioners shared significant, documented portions of a testing-related procedure (rare for lab testing)
`78`	Return to operating room	Use where applicable for operative cases requiring re-entry (not typical for this lab test)
`80`	Assistant at surgery	Use when an assistant is involved in a related surgical procedure (not typical for this lab test)
`AD`	Medical supervision by a physician: more than four concurrent anesthesia procedures	Use per payer rules when anesthesia supervision applies to specimen collection in special settings

Taxonomy Code	Specialty	Notes
`207RH0000X`	Infectious Disease	Specialists who commonly order confirmatory Lyme testing
`207RC0000X`	Internal Medicine	Primary care physicians who evaluate tick-borne illness
`208000000X`	Family Medicine	Clinicians in outpatient settings who collect specimens and order testing
`171M00000X`	Pathology & Laboratory Medicine	Laboratory directors or pathologists overseeing testing and reporting
`363LF0000X`	Phlebotomy/Specimen Collection	Personnel who perform specimen collection and handling

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`A69.20`	Lyme disease, unspecified	Directly indicates Lyme disease testing and is commonly used when serologic confirmation is sought
`A69.21`	Meningitis due to Lyme disease	Neurologic manifestations prompting serologic testing including IgM immunoblot
`A69.23`	Lyme arthritis	Joint symptoms that often trigger confirmatory Borrelia antibody testing
`R50.9`	Fever, unspecified	Nonspecific systemic symptom that may prompt evaluation for tick-borne infections including Lyme disease
`R53.83`	Other fatigue	Common symptom in early or disseminated Lyme disease leading to serologic evaluation
`L90.5`	Erythema chronicum migrans	Classic skin lesion of early Lyme disease that often prompts immediate serologic testing and clinical evaluation

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Commonly performed immediately before `0041U` to obtain the serum sample sent to IGeneX
`99000`	Handling and/or conveyance of specimen for transfer from the physician to a lab (when billable)	May apply when billing for specimen transportation or handling per payer policy
`80061`	Lipid panel (total, HDL, triglycerides)	Example of other laboratory tests that may be ordered at the same visit; not specific to Lyme testing
`86318`	Immunoassay for infectious agent antibody, qualitative or semiquantitative, multiple-step method; each additional step	Represents immunoassay methods commonly used in serologic testing workflows alongside specialized immunoblots
`87070`	Culture, bacterial; any source, aerobic, routine, with isolation and presumptive identification of isolates	May be ordered in differential diagnostic evaluation if other infections are considered

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 Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

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

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CPT 0041U: Lyme ImmunoBlot IgM (IGeneX)

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Billing Code Overview

OpenPayer

CPT 0041U: Lyme ImmunoBlot IgM (IGeneX)

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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