CPT 0115U: ePlex Respiratory Pathogen (RP) Panel, Multiplex NAAT

CPT code 0115U is a Proprietary Laboratory Analyses (PLA) code for the ePlex® Respiratory Pathogen (RP) Panel from GenMark Diagnostics, Inc., an automated multiplex nucleic acid diagnostic test performed on a nasopharyngeal specimen to detect 20 common respiratory pathogens (18 viral and 2 bacterial); service type: automated molecular multiplexed nucleic acid diagnostic testing; typical site of service: clinical laboratory or hospital laboratory processing nasopharyngeal specimens for patients suspected of respiratory tract infections.

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CPT 0115U: ePlex Respiratory Pathogen (RP) Panel, Multiplex NAAT

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Get alerted when payer policies referencing 0115U are released or updated.

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Clinical & Coding Specifications

Clinical Context

A symptomatic adult or pediatric patient presents to an outpatient clinic, urgent care, emergency department, or hospital with acute respiratory symptoms such as fever, cough, nasal congestion, sore throat, dyspnea, or hypoxia. The clinician suspects a viral or bacterial respiratory infection and orders a multiplex nucleic acid amplification test to identify common respiratory pathogens rapidly. A nasopharyngeal swab is collected per facility infection-control procedures and sent to the laboratory. The laboratory performs the GenMark Diagnostics ePlex® Respiratory Pathogen (RP) Panel, reported with CPT code 0115U, which simultaneously detects 18 viral and 2 bacterial targets. Results are returned to the ordering clinician to inform infection-control decisions, antiviral or antibiotic selection, cohorting, and disposition (discharge, admission, or isolation). Typical sites of service include outpatient clinics, urgent care centers, emergency departments, and inpatient hospital laboratories. Patient scenarios include seasonal influenza-like illness, suspected COVID-19 with atypical presentation, bronchiolitis in infants, or immunocompromised patients with unexplained respiratory symptoms where comprehensive pathogen identification affects management and isolation precautions.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87070`	Culture, bacterial, any source; with isolation and presumptive identification of isolates	May be ordered alongside molecular panel when bacterial culture confirmation or antimicrobial susceptibility testing is needed for bacterial pathogens identified by the panel
`87428`	Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, amplified probe technique	May be ordered separately or reflexed in workflows during high-sensitivity influenza confirmation or for platforms not detecting all subtypes
`87635`	Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), amplified probe technique	May be ordered in parallel or reflex to confirm SARS-CoV-2 when institution policy requires dedicated SARS-CoV-2 testing or for cycle threshold reporting workflows
`87804`	Infectious agent antigen detection by immunoassay, multiple step method, qualitative or semi-quantitative; respiratory syncytial virus (RSV)	Rapid antigen tests may be used at point-of-care with the ePlex panel providing comprehensive confirmation and additional targets
`99000`	Handling and/or conveyance of specimen for transfer from one laboratory to another	Applicable when specimen is sent to a reference lab that performs the proprietary PLA test

Related Modifiers

6 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…
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…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

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…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
207LP2900X	Pain Medicine (Anesthesiology) Physician	An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chr…
1835P0200X	Pediatric Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in the delivery of patient care services by pharmacists that ensures the sa…
225XL0004X	Low Vision Occupational Therapist	Occupational therapists enable children and adults with visual impairment to engage in their chosen daily living activities safely and as independentl…
193400000X	Single Specialty Group	A business group of one or more individual practitioners, all of who practice with the same area of specialization.
207RH0003X	Hematology & Oncology Physician	An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy t…

Related ICD-10-CM Codes

26 rows

ICD-10-CM Code	Description
A49.9	Bacterial infection, unspecified
B34.9	Viral infection, unspecified
B97.89	Other viral agents as the cause of diseases classified elsewhere
J00	Acute nasopharyngitis [common cold]
J02.9	Acute pharyngitis, unspecified
J06.9	Acute upper respiratory infection, unspecified
J10.1	Influenza due to other identified influenza virus with other respiratory manifestations
J11.1	Influenza due to unidentified influenza virus with other respiratory manifestations
J12.9	Viral pneumonia, unspecified
J13	Pneumonia due to Streptococcus pneumoniae

Showing 1–10 of 26

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

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

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.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87070`	Culture, bacterial, any source; with isolation and presumptive identification of isolates	May be ordered alongside molecular panel when bacterial culture confirmation or antimicrobial susceptibility testing is needed for bacterial pathogens identified by the panel
`87428`	Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, amplified probe technique	May be ordered separately or reflexed in workflows during high-sensitivity influenza confirmation or for platforms not detecting all subtypes
`87635`	Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), amplified probe technique	May be ordered in parallel or reflex to confirm SARS-CoV-2 when institution policy requires dedicated SARS-CoV-2 testing or for cycle threshold reporting workflows
`87804`	Infectious agent antigen detection by immunoassay, multiple step method, qualitative or semi-quantitative; respiratory syncytial virus (RSV)	Rapid antigen tests may be used at point-of-care with the ePlex panel providing comprehensive confirmation and additional targets
`99000`	Handling and/or conveyance of specimen for transfer from one laboratory to another	Applicable when specimen is sent to a reference lab that performs the proprietary PLA test

Related Modifiers

6 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…
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…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

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…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
207LP2900X	Pain Medicine (Anesthesiology) Physician	An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chr…
1835P0200X	Pediatric Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in the delivery of patient care services by pharmacists that ensures the sa…
225XL0004X	Low Vision Occupational Therapist	Occupational therapists enable children and adults with visual impairment to engage in their chosen daily living activities safely and as independentl…
193400000X	Single Specialty Group	A business group of one or more individual practitioners, all of who practice with the same area of specialization.
207RH0003X	Hematology & Oncology Physician	An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy t…

Related ICD-10-CM Codes

26 rows

ICD-10-CM Code	Description
A49.9	Bacterial infection, unspecified
B34.9	Viral infection, unspecified
B97.89	Other viral agents as the cause of diseases classified elsewhere
J00	Acute nasopharyngitis [common cold]
J02.9	Acute pharyngitis, unspecified
J06.9	Acute upper respiratory infection, unspecified
J10.1	Influenza due to other identified influenza virus with other respiratory manifestations
J11.1	Influenza due to unidentified influenza virus with other respiratory manifestations
J12.9	Viral pneumonia, unspecified
J13	Pneumonia due to Streptococcus pneumoniae

Showing 1–10 of 26

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

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

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 0115U: ePlex Respiratory Pathogen (RP) Panel, Multiplex NAAT

Sign up for cpt 0115U policy alerts

OpenPayer

CPT 0115U: ePlex Respiratory Pathogen (RP) Panel, Multiplex NAAT

Sign up for cpt 0115U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

CPT 0115U: ePlex Respiratory Pathogen (RP) Panel, Multiplex NAAT

Sign up for cpt 0115U policy alerts

CPT 0115U: ePlex Respiratory Pathogen (RP) Panel, Multiplex NAAT

Sign up for cpt 0115U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What is CPT 0115U used to report?

In which clinical settings is the ePlex RP Panel typically used?

Which pathogens or diagnoses are relevant when ordering or interpreting this test?

What other laboratory tests or CPT codes might be ordered alongside 0115U?

Which payers are listed as covering this code in the summary metadata?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What is CPT 0115U used to report?

In which clinical settings is the ePlex RP Panel typically used?

Which pathogens or diagnoses are relevant when ordering or interpreting this test?

What other laboratory tests or CPT codes might be ordered alongside 0115U?

Which payers are listed as covering this code in the summary metadata?

References