Summary & Overview
CPT 0142U: ePlex BCID Gram–Negative Panel for Positive Blood Cultures
CPT code 0142U designates a Proprietary Laboratory Analyses (PLA) test for the ePlex® BCID gram–negative panel by GenMark Diagnostics, a rapid molecular diagnostic assay for detecting gram–negative bacterial targets, key resistance genes, and Candida from positive blood cultures. This code matters nationally because rapid identification of bloodstream pathogens and resistance markers can influence antibiotic selection, infection control, and hospital resource use.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical use of the assay, the typical site of service (hospital or reference laboratories), and the national implications for laboratory and inpatient care pathways. The publication describes how the code is used for reporting a single-vendor, specific-test PLA and summarizes what stakeholders should know about coding clarity for proprietary assays.
The report provides benchmarks and payer coverage context where available, highlights policy considerations for PLA codes, and situates the clinical role of the ePlex BCID gram–negative panel within diagnostic workflows for bacteremia and candidemia. Data not available in the input will be noted as such in relevant sections.
Billing Code Overview
CPT code 0142U is a Proprietary Laboratory Analyses (PLA) code for the ePlex® BCID gram–negative panel from GenMark Diagnostics Inc. The test uses an automated amplified probe technique for rapid detection of multiple bloodstream infection targets, including 21 gram–negative bacterial targets, 6 resistance genes, 1 pan gram–negative bacterial target, and 1 pan Candida target from positive blood cultures.
Service type: Clinical laboratory molecular diagnostic test for pathogen and resistance gene detection.
Typical site of service: Hospital clinical laboratory or centralized reference laboratory processing positive blood culture specimens.
Clinical & Coding Specifications
Clinical Context
A hospitalized adult presents with signs of sepsis: fever, hypotension, tachycardia, and altered mental status. Blood cultures obtained at the bedside grow organisms on Gram stain showing gram-negative bacilli. The clinical team requests rapid pathogen identification and resistance marker detection to guide early antimicrobial therapy. The laboratory performs the ePlex® BCID gram–negative panel using an automated amplified probe technique on a positive blood culture bottle. Results reporting includes identification of targeted gram-negative bacteria, detection of key resistance genes, and pan-Candida/pan-gram-positive targets to assist in narrowing or broadening empiric therapy. Typical workflow: blood cultures drawn in the emergency department or inpatient unit → incubation and growth detected in automated blood culture system → positive bottle forwarded to microbiology lab → laboratory technologist performs the ePlex® BCID gram–negative panel (report with 0142U) → results communicated to the treating team and antimicrobial stewardship when available. Typical site of service: hospital inpatient laboratory and hospital emergency department with specimen collection at bedside. Typical patient scenario: adult with suspected bacteremia/sepsis after urinary tract infection or intra-abdominal infection, positive blood culture with gram-negative bacilli on Gram stain, requiring rapid organism and resistance gene identification to optimize antimicrobial therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — full global service | Use when no modifier is applicable and the service is reported normally. |
22 | Increased procedural services | Use when the laboratory documents substantial additional work or complexity beyond the typical test (rare for PLA tests). |
26 | Professional component | Use when only the professional interpretation/component is billed separately by a physician or qualified practitioner. |
52 | Reduced services | Use when the test is partially reduced or not completed as originally intended. |
53 | Discontinued procedure | Use if testing was started but discontinued for reason unrelated to patient’s condition. |
62 | Two surgeons — concurrent modifiers for surgical context | Uncommon for this lab test; used only if related to bundled surgical billing requiring attribution. |
78 | Return to operating room for a related procedure | Not typically applicable but listed for completeness when lab testing follows reoperation billing events. |
80 | Assistant surgeon | Not typically applicable; used if billing context requires reporting of assistant involvement in a related surgical episode. |
82 | Assistant surgeon (when qualified resident not available) | Same limited relevance as 80 — included when applicable to associated operative services. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures | Not directly applicable to the lab test; included when anesthesia-related billing occurs in the same encounter. |
QX | CRNA service with medical direction | Not directly applicable to the lab test; included for completeness in perioperative encounters. |
QY | Medical direction of one CRNA by an anesthesiologist | Not directly applicable to the lab test; included for perioperative billing context. |
TC | Technical component | Use when only the technical component (laboratory instrumentation and processing) is billed by the performing laboratory separate from professional interpretation. |
AD | Medical team participation in global surgical package | Rarely applicable; used if lab testing is part of an episode where an additional medical team is involved. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 208000000X | Pathology | Clinical laboratory/pathology oversight, interpretation and reporting of microbiology results. |
| 207Q00000X | Infectious Disease | Clinicians who order and act on rapid blood culture identification for antimicrobial management. |
| 207L00000X | Hospitalist | Inpatient physicians ordering tests and managing sepsis/bacteremia patients. |
| 333600000X | Clinical Laboratory Technologist/Technician | Laboratory professionals performing the ePlex assay and processing specimens. |
| 363L00000X | Microbiology Technician | Specialists in bacteriology and molecular detection performing and validating the test. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
A41.9 | Sepsis, unspecified organism | Common presenting diagnosis prompting rapid blood-culture-based molecular testing to identify causative gram-negative pathogens. |
A41.5 | Sepsis due to other Gram-negative organisms | Directly relevant — indicates gram-negative sepsis where the ePlex gram–negative panel assists in rapid identification. |
R65.20 | Severe sepsis without septic shock | Indicates systemic inflammatory response and organ dysfunction where rapid pathogen ID influences management. |
R65.21 | Severe sepsis with septic shock | High-acuity scenario requiring rapid detection of organisms and resistance markers to guide therapy. |
N39.0 | Urinary tract infection, site not specified | UTI can be a source of gram-negative bacteremia leading to positive blood cultures tested with this panel. |
K65.0 | Acute peritonitis | Intra-abdominal infections are common sources of gram-negative bacteremia prompting this test. |
J18.9 | Pneumonia, unspecified organism | Pneumonia can lead to bacteremia with gram-negative organisms; rapid ID supports targeted therapy. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
87070 | Culture, blood, aerobic, with isolation and presumptive identification of aerobic organisms | Performed prior to or alongside molecular testing; provides organism isolation and susceptibility workflow. |
87076 | Culture, blood, aerobic, with isolation and presumptive identification of organisms; any source, multiple pathogens (automated) | Alternate culture code used in bacteremia workups; complements rapid PLA testing by providing isolates for full susceptibility. |
87471 | Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique | Example molecular amplification CPT; included to represent molecular nucleic acid amplification methodology in lab workflows (different analyte). |
87499 | Unlisted molecular pathology procedure | Occasionally used historically when no PLA code existed; for PLA-coded test 0142U is reported instead. |
87077 | Culture, blood, aerobic and anaerobic, with isolation and presumptive identification | Provides broader culture coverage alongside the rapid gram-negative panel when anaerobic pathogens are suspected. |