CPT 0043U: Tick–Borne Relapsing Fever Borrelia ImmunoBlot IgM

CPT code 0043U is a Proprietary Laboratory Analyses (PLA) code for the Tick–Borne Relapsing Fever (TBRF) Borrelia ImmunoBlot IgM test from IGeneX Inc., a serologic immunoblot assay that detects IgM antibodies to four recombinant Borrelia protein groups to aid in the laboratory evaluation of suspected tick-borne relapsing fever or related Borrelia infections; service type: diagnostic specialty laboratory test; typical site of service: reference or commercial clinical laboratory (ambulatory or outpatient specimen collection).

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CPT 0043U: Tick–Borne Relapsing Fever Borrelia ImmunoBlot IgM

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Get alerted when payer policies referencing 0043U are released or updated.

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Clinical & Coding Specifications

Clinical Context

A 34-year-old patient presents to an infectious disease clinic with several weeks of intermittent fevers, recurrent headaches, fatigue, and a history of recent tick exposure while hiking in an endemic area. The clinician suspects tick-borne relapsing fever (TBRF) or another Borrelia-related infection and orders a specialized serologic test to detect early immune response. The specimen (serum) is collected in the outpatient laboratory or clinic phlebotomy area and sent to IGeneX Inc. for the proprietary Tick–Borne Relapsing Fever Borrelia ImmunoBlot IgM assay (0043U). Results are reviewed by the ordering clinician; a positive IgM immunoblot supports recent or acute infection and informs further management, public health reporting if applicable, and possible confirmatory testing or treatment decisions. Typical sites of service include outpatient clinic, outpatient laboratory, urgent care, and reference laboratory processing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80048`	Basic metabolic panel (BMP)	Often ordered alongside infectious disease testing to assess baseline metabolic status and organ function prior to treatment.
`86580`	Skin test for tuberculosis (tine test)	May be ordered in the differential evaluation for febrile illnesses or when evaluating immune status; not specific but commonly used in infectious workups.
`87471`	Infectious agent detection by nucleic acid (for example, Borrelia)	Molecular testing for Borrelia species may be ordered in parallel or as confirmatory testing to serology depending on clinical suspicion and timing of illness.
`87070`	Culture, bacterial; any source except blood, aerobic	When suspicious for concurrent bacterial infections or to evaluate secondary infections from tick exposures, cultures may be obtained.
`99000`	Handling and/or conveyance of a specimen for transfer from the patient to the laboratory	Billed when specimen handling or transfer services apply in the specimen transport chain to a reference lab.

Related Modifiers

5 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
82	Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…	- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
2080P0006X	Developmental - Behavioral Pediatrics Physician	A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal…
163WP2201X	Ambulatory Care Registered Nurse	Nursing Service Providers · Registered Nurse
207UN0901X	Nuclear Cardiology Physician	A nuclear medicine physician who specializes in nuclear cardiology.
243U00000X	Radiology Practitioner Assistant	A Radiology Practitioner Assistant (RPA) is a health professional certified as a registered radiographer with the American Registry of Radiologic Tech…

Related ICD-10-CM Codes

23 rows

ICD-10-CM Code	Description
A69.20	Lyme disease, unspecified
A69.23	Arthritis due to Lyme disease
A69.29	Other conditions associated with Lyme disease
B37.9	Candidiasis, unspecified
G44.1	Vascular headache, not elsewhere classified
J06.9	Acute upper respiratory infection, unspecified
L03.90	Cellulitis, unspecified
L29.9	Pruritus, unspecified
M79.2	Neuralgia and neuritis, unspecified
N39.0	Urinary tract infection, site not specified

Showing 1–10 of 23

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

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

CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

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

CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

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

CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression 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 Gene Panel

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: 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 Transcripts

Showing 1–10 of 536

Frequently Asked Questions

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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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80048`	Basic metabolic panel (BMP)	Often ordered alongside infectious disease testing to assess baseline metabolic status and organ function prior to treatment.
`86580`	Skin test for tuberculosis (tine test)	May be ordered in the differential evaluation for febrile illnesses or when evaluating immune status; not specific but commonly used in infectious workups.
`87471`	Infectious agent detection by nucleic acid (for example, Borrelia)	Molecular testing for Borrelia species may be ordered in parallel or as confirmatory testing to serology depending on clinical suspicion and timing of illness.
`87070`	Culture, bacterial; any source except blood, aerobic	When suspicious for concurrent bacterial infections or to evaluate secondary infections from tick exposures, cultures may be obtained.
`99000`	Handling and/or conveyance of a specimen for transfer from the patient to the laboratory	Billed when specimen handling or transfer services apply in the specimen transport chain to a reference lab.

Related Modifiers

5 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
82	Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…	- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
2080P0006X	Developmental - Behavioral Pediatrics Physician	A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal…
163WP2201X	Ambulatory Care Registered Nurse	Nursing Service Providers · Registered Nurse
207UN0901X	Nuclear Cardiology Physician	A nuclear medicine physician who specializes in nuclear cardiology.
243U00000X	Radiology Practitioner Assistant	A Radiology Practitioner Assistant (RPA) is a health professional certified as a registered radiographer with the American Registry of Radiologic Tech…

Related ICD-10-CM Codes

23 rows

ICD-10-CM Code	Description
A69.20	Lyme disease, unspecified
A69.23	Arthritis due to Lyme disease
A69.29	Other conditions associated with Lyme disease
B37.9	Candidiasis, unspecified
G44.1	Vascular headache, not elsewhere classified
J06.9	Acute upper respiratory infection, unspecified
L03.90	Cellulitis, unspecified
L29.9	Pruritus, unspecified
M79.2	Neuralgia and neuritis, unspecified
N39.0	Urinary tract infection, site not specified

Showing 1–10 of 23

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

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

CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

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

CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

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

CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression 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 Gene Panel

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: 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 Transcripts

Showing 1–10 of 536

Frequently Asked Questions

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.

OpenPayer

CPT 0043U: Tick–Borne Relapsing Fever Borrelia ImmunoBlot IgM

Sign up for cpt 0043U policy alerts

OpenPayer

CPT 0043U: Tick–Borne Relapsing Fever Borrelia ImmunoBlot IgM

Sign up for cpt 0043U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

CPT 0043U: Tick–Borne Relapsing Fever Borrelia ImmunoBlot IgM

Sign up for cpt 0043U policy alerts

CPT 0043U: Tick–Borne Relapsing Fever Borrelia ImmunoBlot IgM

Sign up for cpt 0043U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does CPT code 0043U represent?

Where is the 0043U test performed and what specimen is collected?

What does a positive 0043U (IgM immunoblot) result indicate?

What other tests are commonly ordered with the 0043U assay?

Which payers are listed as covering CPT 0043U and does the page provide reimbursement rates?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does CPT code 0043U represent?

Where is the 0043U test performed and what specimen is collected?

What does a positive 0043U (IgM immunoblot) result indicate?

What other tests are commonly ordered with the 0043U assay?

Which payers are listed as covering CPT 0043U and does the page provide reimbursement rates?

References