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    OpenPayerBilling CodesProprietary Laboratory AnalysesCPT cpt-0058u-merkel-smt-oncoprotein-antibody-titer
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    CPT 0058U: Merkel SmT Oncoprotein Antibody Titer

    CPT code 0058U is a Proprietary Laboratory Analyses (PLA) code for the Merkel SmT Oncoprotein Antibody Titer performed by the University of Washington Department of Laboratory Medicine; it detects and quantifies antibodies to the Merkel cell polyomavirus small T (sT) antigen/oncoprotein to support evaluation and monitoring of Merkel cell carcinoma (MCC). Service type: laboratory diagnostic serology/antibody quantitation. Typical site of service: clinical laboratory or hospital laboratory specimen collection with analysis performed by the reference laboratory.

    For related coverage guidance, see recent payer policy updates: RTM Testing of Homocysteine Metabolism-Related Conditions, Multimarker Serum Testing Related to Ovarian Cancer, B-Hemolytic Streptococcus Testing.

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with a history of a rapidly growing, firm, painless cutaneous nodule on the forearm is diagnosed with Merkel cell carcinoma (MCC) by biopsy. The treating dermatologic oncologist orders the Merkel SmT Oncoprotein Antibody Titer performed by the University of Washington Department of Laboratory Medicine to detect and quantify antibodies to the Merkel cell polyomavirus small T (sT) antigen. The test is used as a tumor-associated serologic marker to aid in baseline staging, to help assess tumor burden, and to monitor disease recurrence or response during surveillance after definitive therapy (surgery, radiation, or systemic therapy).

    Typical clinical workflow:

    • Patient evaluated in dermatology or oncology clinic; biopsy confirms MCC.

    • Order placed for proprietary laboratory test 0058U with clinical indication of MCC and intent (baseline serology or surveillance).

    • Blood draw performed in outpatient phlebotomy or oncology infusion center; specimen shipped per University of Washington instructions.

    • Laboratory performs proprietary assay and reports quantitative sT antibody titer; result is returned to ordering clinician and placed in the medical record.

    • Clinician interprets titer in the context of imaging, pathology, and clinical exam to inform surveillance intervals and assessment of treatment response.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    86318Antibody; infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitativeCommon serologic platform used for other antibody assays; conceptually similar immunoassay methodology though not specific to this PLA
    86850Tissue identification by immunoassay techniqueComplementary tissue-based testing in MCC diagnostic workflows when correlating serology with tumor antigen expression
    88305Pathology, surgical; level IV - surgical pathology, gross and microscopic examinationPerformed on the diagnostic biopsy or excision specimen that establishes MCC diagnosis prior to ordering 0058U
    96413Chemotherapy administration, intravenous infusion, for therapeutic drugsSystemic therapy administration CPT that may occur as part of MCC treatment alongside surveillance with 0058U
    77334Radiation therapy; complex treatment devices and calculations (per treatment)Radiation therapy delivery CPT often used in definitive or adjuvant treatment of MCC; serologic monitoring with 0058U may occur during follow-up

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    26Modifier 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…
    52Modifier ‑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…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    207P00000XEmergency Medicine PhysicianAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    164W00000XLicensed Practical NurseAn individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required f…
    207VC0300XComplex Family Planning PhysicianA complex family planning physician specializes in the diagnosis and treatment of individuals with complex reproductive needs. These physicians are ex…
    213E00000XPodiatristA podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that l…

    Related Payer Policy Updates

    Specialty: Genetic & Molecular Testing1 / 3

    2 rows

    PolicyPayerEffective Date
    RTM Testing of Homocysteine Metabolism-Related ConditionsOscar Health2026-10-01
    Multimarker Serum Testing Related to Ovarian CancerBlue Cross Blue Shield - Rhode Island2026-09-01

    Related Codes

    CPT-0001U-PRECISETYPE-HEA-MULTIPLEX-RBC-ANTIGEN-GENOTYPING

    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

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    Frequently Asked Questions

    References

    1. 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. 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. 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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