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    v1.0.28
    OpenPayerBilling CodesProprietary Laboratory AnalysesCPT cpt-0152u-karius-plasma-ngs-pathogen-detection
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    CPT 0152U: Karius NGS Plasma Microbial Detection

    CPT code 0152U is a Proprietary Laboratory Analyses (PLA) code for the Karius® test, a next-generation sequencing (NGS) assay performed on a plasma specimen to detect and report potentially pathogenic organisms; the service type is NGS-based microbial cell-free DNA testing and the typical site of service is an outpatient laboratory or hospital clinical laboratory handling plasma samples.

    For related coverage guidance, see recent payer policy updates: Oral Cancer Screening and Testing, RTM Testing for Alpha-1 Antitrypsin Deficiency, Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policy.

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    Clinical & Coding Specifications

    Clinical Context

    A hospitalized adult patient presents with persistent fever, hemodynamic instability, and negative conventional blood cultures after 48–72 hours of broad-spectrum antibiotic therapy. The treating infectious disease team suspects a deep-seated, atypical, or culture-negative bloodstream infection (for example, fungal, atypical bacterial, or fastidious organisms) or wants earlier pathogen identification to tailor therapy. A plasma-based next-generation sequencing (NGS) test is ordered to detect cell-free microbial DNA using the proprietary Karius® test (0152U).

    The clinical workflow: the ordering clinician (often infectious disease) places the test through the laboratory’s ordering portal or the hospital electronic medical record. A phlebotomy draw of a plasma specimen is performed in the inpatient or outpatient phlebotomy area. The specimen is sent to the performing laboratory (Karius, Inc.) with required paperwork and consent. Results are returned to the ordering clinician typically in 24–72 hours and include detected organisms and quantitative data to guide interpretation. Results inform targeted antimicrobial adjustments, further diagnostic imaging, or source control procedures as clinically indicated. Typical sites of service include inpatient hospital wards, intensive care units, emergency departments, and outpatient specialty infectious disease clinics.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36415Collection of venous blood by venipunctureCommonly used to obtain the plasma specimen sent for the NGS test.

    | 99223 | Initial hospital care, typically 70 minutes or more | Admission history and management for a critically ill patient whose care may prompt ordering this test.

    | 87070 | Culture, bacterial; blood, aerobic and anaerobic, by automated system | Conventional blood cultures performed alongside advanced NGS testing for pathogen detection.

    | 87802 | Infectious agent detection by nucleic acid (DNA or RNA), multiple types or subtypes; amplified probe technique (not NGS) | Represents other molecular diagnostic methods that may be ordered in parallel or prior to NGS testing.

    | G0480 | Drugs/biologicals/toxins/venoms quantification (specimen handling code example for high complexity testing) | Administrative/payor-related HCPCS codes sometimes used to reflect high-complexity laboratory services associated with specialized testing.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    26Modifier 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…
    52Modifier ‑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…
    53Modifier 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…
    62Modifier 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…
    78CPT 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…
    80CPT® 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…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily 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…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    373H00000XDay Training/Habilitation SpecialistIndividuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills t…
    1835E0208XEmergency Medicine PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in the care for patients at the bedside in emergency medicine settings.
    246ZG0701XGraphics Methods Specialist/TechnologistNone
    246ZE0500XEEG Specialist/TechnologistTechnologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Other

    Related Payer Policy Updates

    Specialty: Genetic & Molecular Testing1 / 3

    10 rows

    PolicyPayerEffective Date
    Oral Cancer Screening and TestingOscar Health2027-01-01
    RTM Testing for Alpha-1 Antitrypsin DeficiencyOscar Health2027-01-01
    Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policybcbsvermont2027-01-01
    Genetic Testing for Neurological Disorders (for Kansas Only)UnitedHealthcare2026-10-01
    Carrier Testing Panels for Genetic Diseases (for Kentucky Only)UnitedHealthcare2026-10-01
    Cell-Free Fetal DNA Testing (for Idaho Only)UnitedHealthcare2026-10-01
    Genetic and Molecular TestingProvidence Health Plan2026-10-01
    Next Generation Sequencing for Minimal Residual Disease DetectionProvidence Health Plan2026-10-01
    Pharmacogenetic Panel Testing (for Kansas Only)UnitedHealthcare2026-10-01
    Pharmacogenetic Panel Testing (for New Mexico Only)UnitedHealthcare2026-10-01

    Related Codes

    CPT-0001U-PRECISETYPE-HEA-MULTIPLEX-RBC-ANTIGEN-GENOTYPING

    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

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    Frequently Asked Questions

    References

    1. 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. 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. 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.
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