Summary & Overview
CPT 0109U: MycoDART–PCR Aspergillus Diagnostic Panel
CPT code 0109U designates the MycoDART–PCR™ Aspergillus diagnostic panel, a proprietary molecular test that uses dual amplification real‑time PCR to detect four Aspergillus species in blood, bronchoalveolar lavage fluid, or tissue. This PLA code identifies a single manufacturer‑specific assay and is relevant nationally for hospitals, clinical laboratories, and payers managing testing for invasive fungal infections in immunocompromised patients. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what CPT code 0109U represents, the clinical context for testing (aspergillosis detection in at‑risk patients), typical sites of service (clinical laboratory processing of blood, lavage, or tissue specimens), and how this PLA code is used to uniquely track a manufacturer‑specific diagnostic assay. The publication provides benchmarks and policy context related to billing and coverage for proprietary molecular diagnostics, outlines common modifiers used with PLA and laboratory codes, and summarizes clinical implications for ordering providers and laboratories. Data not provided in the input—such as detailed payer-specific coverage policies, associated taxonomies, and ICD‑10 mappings—is noted as unavailable.
Billing Code Overview
CPT code 0109U is a Proprietary Laboratory Analyses (PLA) code for the MycoDART–PCR™ Aspergillus diagnostic panel from RealTime Laboratories, Inc./MycoDART, Inc. The test is a dual amplification real–time PCR panel that detects the presence or absence of four Aspergillus species in patient specimens. Aspergillus can cause aspergillosis, a fungal infection that primarily affects the lungs and can involve other organs in immunocompromised patients.
Service Type: Proprietary molecular diagnostic test (PCR panel)
Typical Site of Service: Clinical laboratory processing specimens from inpatient or outpatient settings
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 56-year-old immunocompromised patient with a history of hematologic malignancy presents with progressive fever, cough, dyspnea, and new focal pulmonary infiltrates on chest imaging. An intensivist and infectious disease physician evaluate the patient in the inpatient setting. Bronchoalveolar lavage (BAL) fluid is obtained during bronchoscopy and submitted to the hospital clinical laboratory for fungal testing. The laboratory performs the MycoDART–PCR™ Aspergillus diagnostic panel, a dual amplification real–time PCR assay that detects four clinically relevant Aspergillus species from blood, BAL fluid, or tissue. Results are reported as presence/absence of Aspergillus DNA to guide antimicrobial selection and infection control decisions. Typical sites of service include the hospital inpatient laboratory, hospital outpatient laboratory or reference laboratory, and the procedure (bronchoscopy) may occur in the operating room, bronchoscopy suite, or intensive care unit. The clinical workflow includes specimen collection (blood/BAL/tissue), specimen accessioning, PCR testing under the laboratory’s PLA test protocol, result validation by laboratory personnel, and result delivery to the treating team for correlation with clinical and radiographic findings.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
TC | Technical component | Use when billing the laboratory/testing facility’s technical portion only if the performing lab or facility bills separately for equipment, supplies, and personnel. |