Clinical Context
A 38-year-old patient presents to an infectious disease clinic with a history of multiple tick exposures while hiking in a region endemic for relapsing fever. The patient reports recurrent febrile episodes, headache, myalgias, and a transient rash over the prior several weeks. Prior routine Lyme serology was negative or equivocal. The clinician orders the proprietary Tick–Borne Relapsing Fever (TBRF) Borrelia ImmunoBlots IgG (0044U) from IGeneX Inc. to detect IgG antibodies to four Borrelia species associated with tick-borne relapsing fever.
Workflow:
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The ordering clinician documents clinical suspicion for relapsing fever or nonspecific tick-borne illness in the outpatient chart and places the laboratory order for 0044U.
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A phlebotomist obtains a serum specimen at an ambulatory clinic or outpatient lab; typical site of service is an outpatient clinic, physician office, or independent laboratory collection center.
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The specimen is sent to the performing laboratory (IGeneX Inc.) with appropriate test requisition and clinical history; the lab performs the immunoblot and reports qualitative IgG results for the four Borrelia species.
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Results are reviewed by the ordering clinician; positive IgG may support a diagnosis of prior or ongoing tick-borne relapsing fever infection and guide additional clinical evaluation or therapy. Negative results may prompt consideration of acute testing, alternative diagnoses, or repeat testing based on timing of exposure and symptom onset.
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Billing for the test uses the PLA code 0044U with appropriate modifier(s) as clinically indicated and the laboratory’s CLIA and payer contractual details applied during claims submission.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|
80053 | Comprehensive metabolic panel (CMP) | Performed alongside 0044U to assess baseline organ function prior to therapy when systemic infection is suspected. |
| 86430 | Brucella antibody, serological test (note: example serology code) | Performed in differential serologic workup for febrile tick-borne or zoonotic illnesses; indicates additional serology panels commonly ordered in parallel.
| 87802 | Infectious agent antigen detection by immunoassay with direct optical observation; per single-step method (example rapid antigen) | Represents point-of-care testing that may precede more specific laboratory immunoblots such as 0044U.
| 36415 | Collection of venous blood by venipuncture | The specimen collection code commonly billed or documented when drawing blood for 0044U.
| 99000 | Handling and/or conveyance of specimen for transfer from physician's office to a laboratory (historical/limited use) | Used when additional specimen handling or courier services are billed in association with sending 0044U to a reference laboratory.
Note: If payer or local billing rules require alternate or specific CPT codes for related services (collection, processing, or additional serologic testing), those codes are billed in the clinical workflow surrounding 0044U.