CPT 0118U: Viracor TRAC Donor-Derived Cell-Free DNA Assay

CPT code 0118U identifies the Viracor TRAC™ donor–derived cell–free DNA (dd–cfDNA) assay, a proprietary next-generation sequencing laboratory test used to quantify the percentage of donor-derived cell-free DNA in the blood of solid organ transplant recipients. This biomarker-based molecular assay is used for noninvasive surveillance of allograft injury or rejection, with implications for early detection and post-transplant management. Nationally, adoption of PLA codes like 0118U reflects growth in proprietary, manufacturer‑specific molecular diagnostics that support precision transplant care.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the test, payer coverage considerations, and what to expect in reimbursement and utilization benchmarking. The publication examines coding and billing context, common modifiers, typical sites of service, and clinical scenarios driving test utilization. It also summarizes the role of dd–cfDNA monitoring in transplant surveillance and where this PLA code fits within the broader landscape of transplant diagnostics and laboratory billing nationally.

Billing Code Overview

CPT code 0118U is a Proprietary Laboratory Analyses (PLA) code for the Viracor TRAC™ donor–derived cell–free DNA (dd–cfDNA) assay produced by Viracor Eurofins. The test uses next generation sequencing to quantify the percentage of donor-derived cell-free DNA in the blood of a transplant recipient and is intended to monitor for allograft injury or rejection following a solid organ transplant.

Service type: Laboratory testing using next generation sequencing to measure dd–cfDNA percentage
Typical site of service: Clinical laboratory or hospital outpatient laboratory performing specialized molecular diagnostics

Clinical Context

A 52-year-old male recipient of a deceased-donor kidney transplant presents for routine post-transplant surveillance. The patient is 6 months post-transplant, on maintenance immunosuppression, and is asymptomatic with stable serum creatinine but the transplant team orders a donor-derived cell-free DNA test to screen for subclinical allograft injury and early rejection. A peripheral blood sample is collected in the clinic or outpatient phlebotomy unit and sent to Viracor Eurofins for the Viracor TRAC™ dd-cfDNA assay. The laboratory performs next-generation sequencing to quantify the percentage of donor-derived cfDNA; results are returned to the transplant nephrology team to aid interpretation alongside clinical data, labs, and, when indicated, biopsy results. Typical site of service is outpatient transplant clinic, hospital outpatient lab, or contracted reference laboratory; service type is Proprietary Laboratory Analyses (PLA) — specialized molecular diagnostic testing.

Coding Specifications

Modifier	Description	When to Use
`00`	Unspecified modifier	Rarely used; not typically appended for PLA testing
`11`	Professional component	Used when reporting only the professional component for procedures that have distinct professional components; generally not applicable to PLA testing alone but may apply when separate professional interpretation is billed

Taxonomy Code	Specialty	Notes
207RC0000X	Transplant Nephrology	Nephrologists who manage kidney transplant recipients ordering dd-cfDNA testing
207RG0300X	Transplant Surgery	Transplant surgeons involved in postoperative care and surveillance
207RN0401X	Clinical Molecular Genetics Laboratory	Laboratory specialists directing molecular diagnostic testing
207V00000X	Pathology	Pathologists overseeing laboratory testing and interpretations
363L00000X	Clinical Laboratory	Clinical laboratory professionals performing specimen processing and testing

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`T86.10`	Unspecified complication of kidney transplant	General code for transplant-related complications that may prompt dd-cfDNA testing
`T86.11`	Rejection of kidney transplant	Directly relevant when evaluating for suspected or subclinical allograft rejection using dd-cfDNA
`T86.19`	Other complications of kidney transplant	Used for other transplant complications where graft injury surveillance is indicated
`Z94.0`	Kidney transplant status	Used to indicate transplant recipient status on surveillance testing
`N18.9`	Chronic kidney disease, unspecified	Underlying CKD coding in patients pre- or post-transplant where graft function monitoring is needed
`R94.31`	Abnormal results of other serum enzyme tests	Applied when abnormal lab findings prompt further molecular monitoring including dd-cfDNA
`R94.5`	Abnormal results of liver function studies	Example of nonspecific abnormal labs that can be part of post-transplant monitoring (included for completeness)

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0118U`	Viracor TRAC™ donor-derived cell-free DNA (dd-cfDNA) assay, quantification by next-generation sequencing	Primary PLA code for this specific proprietary dd-cfDNA test performed by Viracor Eurofins
`36415`	Collection of venous blood by venipuncture	Performed immediately prior to sending the sample to the reference lab for dd-cfDNA testing when collection occurs in clinic or outpatient phlebotomy
`85610`	Prothrombin time; single test	Example of routine coagulation monitoring that may be ordered concurrently in transplant follow-up (ancillary test)
`87491`	Infectious agent detection by nucleic acid (e.g., CMV PCR), quantitative, each organism	Representative molecular diagnostic test often ordered in transplant recipients alongside dd-cfDNA for infection surveillance
`88305`	Level IV surgical pathology, gross and microscopic examination	Renal allograft biopsy interpretation code used when dd-cfDNA results prompt a confirmatory graft biopsy

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Summary & Overview