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.

Customize your policy alerts

Sign up for cpt 0065U policy alerts

Get alerted when payer policies referencing 0065U are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

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

Explore openpayer tools

View all tools

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

Key payers covered: Analysis addresses major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Customize your policy alerts

Sign up for cpt 0065U policy alerts

Get alerted when payer policies referencing 0065U are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

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.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`A52.0`	Early syphilis, primary	Active infection where RPR testing is used for diagnosis and treatment monitoring.
`A52.1`	Early syphilis, secondary	Active infection with serologic monitoring via nontreponemal tests like RPR.
`A52.9`	Late syphilis, unspecified	Follow-up serology used to assess prior treatment response or reinfection.
`O98.8`	Other maternal infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium	Prenatal syphilis screening and monitoring of treatment in pregnancy.
`Z11.3`	Encounter for screening for infections with a predominantly sexual mode of transmission	Routine screening context where RPR testing is ordered.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80055`	General health panel (e.g., metabolic function tests)	Often ordered during prenatal visits alongside infectious disease screening; not specific to syphilis but may be batched on the same specimen.
`86592`	Syphilis serological test (qualitative)	A manual or alternative RPR test that may be used for comparison or historical testing; can be performed before or alongside a PLA assay depending on lab workflow.
`86631`	Syphilis antibody, treponemal (e.g., FTA-ABS, TP-PA)	Treponemal confirmatory testing used to confirm reactive RPR results or to establish prior treated infection.
`81162`	Infectious agent detection by nucleic acid (qualitative or quantitative)	In some workflows, nucleic acid tests for sexually transmitted infections may be ordered concurrently, though not specific for syphilis serology.
`99000`	Handling and/or conveyance of specimen	Administrative or handling codes that may apply to specimen transport to a reference laboratory performing `0065U`.

Related Modifiers

7 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…
53	Modifier 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…
59	Modifier 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…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
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…
90	Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…	- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family 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…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
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…
207ZM0300X	Medical Microbiology Physician	A medical microbiologist is expert in the isolation and identification of microbial agents that cause infectious disease. Viruses, bacteria and fungi,…
3245S0500X	Children's Substance Abuse Rehabilitation Facility	A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the tre…
224ZE0001X	Environmental Modification Occupational Therapy Assistant	Occupational therapy assistants provide environmental modifications under the supervision of an occupational therapist. OTAs develop and implement an…
207QA0505X	Adult Medicine Physician	The NUCC recommends this code not be used. Choose a more appropriate code.
207QP0002X	Physician Nutrition Specialist (Family Medicine)	A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, overnutrition, and genetic or acquir…

CPT 0001U: PreciseType HEA Multiplex Erythrocyte Antigen Assay

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

CPT 0002U: Urine Metabolomic Polyp Risk Assay (PolypDX™)

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

CPT 0003U: Overa™ (OVA1 Next Generation) Ovarian Cancer Risk Assay

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

CPT 0005U: ExosomeDx Prostate (IntelliScore) Urine Gene Expression Risk 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 Panel, Gene Sequence Analysis

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: Cordant CORE™ 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 Transcript Testing

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.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`A52.0`	Early syphilis, primary	Active infection where RPR testing is used for diagnosis and treatment monitoring.
`A52.1`	Early syphilis, secondary	Active infection with serologic monitoring via nontreponemal tests like RPR.
`A52.9`	Late syphilis, unspecified	Follow-up serology used to assess prior treatment response or reinfection.
`O98.8`	Other maternal infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium	Prenatal syphilis screening and monitoring of treatment in pregnancy.
`Z11.3`	Encounter for screening for infections with a predominantly sexual mode of transmission	Routine screening context where RPR testing is ordered.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80055`	General health panel (e.g., metabolic function tests)	Often ordered during prenatal visits alongside infectious disease screening; not specific to syphilis but may be batched on the same specimen.
`86592`	Syphilis serological test (qualitative)	A manual or alternative RPR test that may be used for comparison or historical testing; can be performed before or alongside a PLA assay depending on lab workflow.
`86631`	Syphilis antibody, treponemal (e.g., FTA-ABS, TP-PA)	Treponemal confirmatory testing used to confirm reactive RPR results or to establish prior treated infection.
`81162`	Infectious agent detection by nucleic acid (qualitative or quantitative)	In some workflows, nucleic acid tests for sexually transmitted infections may be ordered concurrently, though not specific for syphilis serology.
`99000`	Handling and/or conveyance of specimen	Administrative or handling codes that may apply to specimen transport to a reference laboratory performing `0065U`.

Related Modifiers

7 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…
53	Modifier 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…
59	Modifier 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…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
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…
90	Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…	- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family 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…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
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…
207ZM0300X	Medical Microbiology Physician	A medical microbiologist is expert in the isolation and identification of microbial agents that cause infectious disease. Viruses, bacteria and fungi,…
3245S0500X	Children's Substance Abuse Rehabilitation Facility	A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the tre…
224ZE0001X	Environmental Modification Occupational Therapy Assistant	Occupational therapy assistants provide environmental modifications under the supervision of an occupational therapist. OTAs develop and implement an…
207QA0505X	Adult Medicine Physician	The NUCC recommends this code not be used. Choose a more appropriate code.
207QP0002X	Physician Nutrition Specialist (Family Medicine)	A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, overnutrition, and genetic or acquir…

CPT 0001U: PreciseType HEA Multiplex Erythrocyte Antigen Assay

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

CPT 0002U: Urine Metabolomic Polyp Risk Assay (PolypDX™)

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

CPT 0003U: Overa™ (OVA1 Next Generation) Ovarian Cancer Risk Assay

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

CPT 0005U: ExosomeDx Prostate (IntelliScore) Urine Gene Expression Risk 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 Panel, Gene Sequence Analysis

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: Cordant CORE™ 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 Transcript Testing

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 0065U: BioPlex 2200 RPR Assay for Syphilis Treatment Management

Sign up for cpt 0065U policy alerts

Billing Code Overview

OpenPayer

CPT 0065U: BioPlex 2200 RPR Assay for Syphilis Treatment Management

Sign up for cpt 0065U policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Related Diagnoses

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related Diagnoses

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

CPT 0065U: BioPlex 2200 RPR Assay for Syphilis Treatment Management

Sign up for cpt 0065U policy alerts

Billing Code Overview

CPT 0065U: BioPlex 2200 RPR Assay for Syphilis Treatment Management

Sign up for cpt 0065U policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Related Diagnoses

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does CPT 0065U represent?

Where is the BioPlex 2200 RPR Assay (0065U) typically performed?

Which CPT modifiers are relevant when billing 0065U?

What related CPT codes might appear with 0065U on a prenatal or syphilis workup?

Which payers are covered in the analysis for code 0065U?

References

Clinical & Coding Specifications

Clinical Context

Related Diagnoses

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does CPT 0065U represent?

Where is the BioPlex 2200 RPR Assay (0065U) typically performed?

Which CPT modifiers are relevant when billing 0065U?

What related CPT codes might appear with 0065U on a prenatal or syphilis workup?

Which payers are covered in the analysis for code 0065U?

References