Summary & Overview
CPT 0062U: SLE–key® Rule Out Autoantibody Profiling Test
CPT code 0062U designates the SLE–key® Rule Out test from Veracis Inc., a Proprietary Laboratory Analyses (PLA) assay that profiles autoantibodies to 80 SLE-related biomarkers and reports an algorithm-derived risk score. As a PLA code, 0062U applies specifically to a single manufacturer’s test, which affects coding precision, payer review, and laboratory billing practices nationally. The code matters because high-complexity, proprietary assays are increasingly used to refine autoimmune disease diagnosis, drive clinical decision-making, and prompt payer coverage reviews.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the test, payer coverage considerations, relevant billing and service settings, and benchmarking content where available. The publication summarizes how proprietary laboratory codes are used in practice, highlights common payer approaches to PLA tests, and identifies the operational and documentation considerations laboratories and providers commonly address when billing such assays. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0062U is a Proprietary Laboratory Analyses (PLA) code for the SLE–key® Rule Out test from Veracis Inc. The test is an autoantibody profiling assay that measures antibodies to 80 biomarkers related to systemic lupus erythematosus (SLE) and applies an algorithmic analysis to generate a reported risk score.
Service type: Laboratory — proprietary molecular/serologic diagnostic assay
Typical site of service: Clinical laboratory or reference laboratory setting, with specimens collected in ambulatory clinics, physician offices, or hospital outpatient phlebotomy sites.
Clinical & Coding Specifications
Clinical Context
A 34-year-old woman presents to a rheumatology clinic with a 6-month history of intermittent arthralgia, photosensitivity, fatigue, and new onset facial rash. Initial autoimmune screening (ANA, anti-dsDNA) is indeterminate. The treating rheumatologist orders the SLE–key® Rule Out test (0062U) from Veracis Inc. as part of a second-line serologic evaluation to clarify autoimmune serology and stratify risk for systemic lupus erythematosus (SLE). A peripheral blood specimen is collected in the clinic, labeled, and shipped to the performing laboratory according to the manufacturer’s specimen handling instructions. The laboratory performs an autoantibody profiling assay measuring antibodies to 80 SLE-related biomarkers and applies a proprietary algorithm to generate a quantitative risk score with interpretive commentary. Results are returned to the ordering clinician and integrated into the clinical assessment to guide further diagnostic evaluation, need for additional serologies, specialist referral, or consideration of immunomodulatory therapy.
Typical site of service: outpatient clinic or ambulatory care setting for specimen collection, with laboratory analysis performed at the proprietary central lab.
Common patient presentation: patients with suspected or early SLE, undifferentiated connective tissue disease, or atypical autoimmune serology where enhanced biomarker profiling may influence diagnostic certainty.
Coding Specifications
| Modifier | Description | When to Use |
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