Summary & Overview
CPT 0065U: BioPlex 2200 RPR Assay for Syphilis Treatment Management
Headline: New PLA CPT code 0065U identifies the BioPlex™ 2200 RPR Assay for syphilis management
Lead: CPT code 0065U is a Proprietary Laboratory Analyses (PLA) code designated for the BioPlex™ 2200 RPR Assay by Bio–Rad® Laboratories, an immunoassay that detects nontreponemal antibodies (rapid plasma reagin) to aid in syphilis treatment management. The code clarifies billing for a single manufacturer-specific laboratory test used in diagnostic and therapeutic monitoring of syphilis.
What this represents and why it matters: PLA code 0065U formalizes billing for a unique, non-generic laboratory assay, enabling standardized reporting and payer review for a test that supports syphilis treatment decisions. Nationally, PLA codes affect how proprietary assays are tracked, priced, and reimbursed across clinical laboratories and hospital labs.
Key payers covered: Analysis addresses major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The publication outlines the clinical context of the BioPlex™ 2200 RPR Assay, expected sites of service, payer coverage considerations, commonly used modifiers, and where to find related procedural and billing guidance. It also summarizes implications for laboratory billing workflows and documentation requirements. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0065U is a Proprietary Laboratory Analyses (PLA) code for the BioPlex™ 2200 RPR Assay from Bio–Rad® Laboratories. The code applies to a single, manufacturer-specific laboratory test: an immunoassay that detects the nontreponemal antibody rapid plasma reagin (RPR) in patient specimens to aid in syphilis treatment management.
Service Type: Laboratory diagnostic immunoassay for nontreponemal antibody (RPR) testing
Typical Site of Service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A 34-year-old pregnant patient presents to an obstetrics clinic for routine prenatal screening and reports a history of prior treated syphilis five years ago. The obstetrician orders serologic testing to evaluate current disease activity and to guide treatment decisions. A venous blood sample is collected at the clinic and sent to the laboratory for the BioPlex™ 2200 RPR Assay, reported under 0065U. The laboratory performs the automated immunoassay for the nontreponemal antibody (rapid plasma reagin) and returns a quantitative result with interpretation to the ordering provider. Results are used by the obstetrician or infectious disease consultant to determine whether retreatment, additional confirmatory treponemal testing, or follow-up titers are needed as part of syphilis treatment management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Use when no special circumstances apply to the service. |
11 | Professional component | Use if reporting only the professional interpretation component and the test has split components. |