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CPT 0165U: VeriMAP Peanut Epitope Assay, Blood Immunoassay Profile

CPT code 0165U designates the VeriMAP™ Peanut Dx–Bead–based Epitope Assay, a Proprietary Laboratory Analyses (PLA) test that maps patient epitopes to provide a probability‑based peanut allergy profile. As a PLA code, 0165U is specific to a single manufacturer’s assay and is used to bill for the lab‑performed immunoassay plus associated bioinformatics interpretation. Nationally, PLA codes like 0165U matter because they standardize reporting for proprietary tests and affect lab billing, coverage determinations, and patient access to advanced diagnostic tools.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise presentation of what 0165U represents clinically, typical service setting, and which major payers are relevant to coverage discussions. The publication also summarizes expected benchmarks and coverage considerations for proprietary allergy diagnostics, highlights clinical context for use in allergy evaluation, and outlines common billing modifiers associated with this code.

This summary is intended for national policy, payer contracting, and laboratory billing audiences who need a focused overview of the CPT PLA code, its clinical role in peanut allergy assessment, and the payer landscape for reimbursement and coverage decisions.

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Billing Code Overview

CPT code 0165U is a Proprietary Laboratory Analyses (PLA) code that applies to a single, manufacturer‑specific laboratory test. Report 0165U for the VeriMAP™ Peanut Dx–Bead–based Epitope Assay from AllerGenis. This is a blood test that maps patient epitopes (immunogenic antigens in food proteins) using a bead‑based microarray immunoassay and bioinformatics to generate a patient food‑allergy profile reported as a probability of peanut allergy.

Service type: Laboratory test — proprietary immunoassay with bioinformatics report
Typical site of service: Clinical laboratory or reference laboratory blood testing facility

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CPT 0165U: VeriMAP Peanut Epitope Assay, Blood Immunoassay Profile

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Get alerted when payer policies referencing 0165U are released or updated.

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Billing Code Overview

Service type: Laboratory test — proprietary immunoassay with bioinformatics report
Typical site of service: Clinical laboratory or reference laboratory blood testing facility

Clinical & Coding Specifications

Clinical Context

A pediatric or adult patient with a history of suspected or confirmed peanut allergy is referred by an allergist or primary care provider for specialized laboratory evaluation. The patient has symptoms suggestive of IgE-mediated food allergy (oral itching, angioedema, urticaria, wheeze, hypotension) or equivocal skin testing and serum specific IgE results. A blood sample is collected in the outpatient clinic or hospital phlebotomy suite and sent to the performing laboratory. The laboratory performs the VeriMAP™ Peanut Dx–Bead–based Epitope Assay (0165U), a proprietary microarray immunoassay with bioinformatics analysis, to map patient-specific IgE binding to peanut epitopes and generate a probability score for peanut allergy. Results are returned to the ordering clinician and integrated into the clinical assessment for counseling, management decisions (such as oral food challenge planning, immunotherapy candidacy, or dietary guidance), and documentation in the patient’s medical record.

Coding Specifications

Modifier	Description	When to Use
`00`	Default - no modifier appended	Use when no special circumstances apply and the full service is provided as described.
`22`	Increased procedural services	Use when laboratory work required substantially greater effort (e.g., extensive specimen handling or custom analysis beyond routine workflow).
`26`	Professional component	Use when reporting only the professional interpretation component separate from the technical laboratory processing.
`52`	Reduced services	Use when the test is partially performed or truncated and full analysis is not completed.
`53`	Discontinued procedure	Use if specimen collection or testing was started but discontinued for clinical reasons.
`59`	Distinct procedural service	Not in provided list — Do not use.
`62`	Two surgeons — Not typically applicable to lab testing	Use only if multiple clinicians share unusual joint responsibilities for specimen procurement (rare).
`78`	Return to operating room — Not applicable	Use only if related invasive procedure required and is reportable (unlikely).
`80`	Assistant surgeon — Not applicable	Use only if another clinician assisted in an invasive procedure associated with specimen collection.
`AD`	Surgical assistant — Not applicable	Use only if an assistant was required for an associated procedure.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist service	Use when an advanced practice clinician independently orders and documents the test under applicable supervision rules.
`CO`	Temporary absence (services performed by a locum tenens)	Use when a locum tenens clinician ordered or interpreted the test.
`QK`	Clinical psychologist service — Not applicable	Use only if an unusual behavioral health component is documented (rare).
`TC`	Technical component	Use when reporting only the laboratory technical component (processing, assay, and report generation) without the professional interpretation.

Taxonomy Code	Specialty	Notes
`207RC0000X`	Allergy & Immunology	Specialists who commonly order and interpret peanut epitope assays.
`207L00000X`	Pediatric Allergy & Immunology	Pediatric specialists ordering testing for suspected food allergy in children.
`208D00000X`	Pediatrics	Primary care pediatricians who refer or order testing as part of evaluation.
`261QM1300X`	Clinical Laboratory	Laboratories and clinical pathologists performing the proprietary assay and reporting results.
`208000000X`	Family Medicine	Family physicians involved in allergy evaluation and management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z13.820`	Encounter for screening for other disorder	Used for screening evaluation in patients with suspected food allergy where testing is ordered.
`T78.01XA`	Anaphylactic reaction due to peanut, initial encounter	Relevant when confirming peanut allergy after a clinical reaction and supporting further management.
`T78.1XXA`	Other adverse food reactions, not elsewhere classified, initial encounter	Used for non-anaphylactic adverse reactions to foods when peanut allergy is in the differential.
`R21`	Rash and other nonspecific skin eruptions	Common presenting symptom prompting evaluation for food allergy including peanut.
`R06.02`	Shortness of breath	Respiratory symptoms that may accompany IgE-mediated food allergy and prompt diagnostic testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86003`	Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative; multiple step method, each specimen	May be used for supplemental allergen-specific IgE testing when standard immunoassays are ordered alongside the proprietary epitope assay.
`86140`	Immunoassay for allergen-specific IgE; quantitative	Commonly performed before or after epitope mapping to measure specific IgE to peanut components (e.g., Ara h proteins) as part of the allergy panel.
`36415`	Collection of venous blood by venipuncture	The phlebotomy code used for blood specimen collection required to perform the `0165U` assay.
`82784`	Alpha-gal IgE (Galactose-alpha-1,3-galactose)	Occasionally ordered in differential evaluation of food allergy presentations to assess for non-peanut carbohydrate-related allergy; may be part of broader workup.
`99000`	Handling and/or conveyance of specimen for transfer from provider to laboratory	Used when specific specimen handling or courier services are separately billable in certain contexts.

CPT 0001U: PreciseType HEA Multiplex Erythrocyte Antigen Assay

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: Urine Metabolomic Polyp Risk Assay (PolypDX™)

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa™ (OVA1 Next Generation) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) Urine Gene Expression Risk 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 Panel, Gene Sequence Analysis

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: Cordant CORE™ 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 Transcript Testing

Showing 1–10 of 536

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.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	Default - no modifier appended	Use when no special circumstances apply and the full service is provided as described.
`22`	Increased procedural services	Use when laboratory work required substantially greater effort (e.g., extensive specimen handling or custom analysis beyond routine workflow).
`26`	Professional component	Use when reporting only the professional interpretation component separate from the technical laboratory processing.
`52`	Reduced services	Use when the test is partially performed or truncated and full analysis is not completed.
`53`	Discontinued procedure	Use if specimen collection or testing was started but discontinued for clinical reasons.
`59`	Distinct procedural service	Not in provided list — Do not use.
`62`	Two surgeons — Not typically applicable to lab testing	Use only if multiple clinicians share unusual joint responsibilities for specimen procurement (rare).
`78`	Return to operating room — Not applicable	Use only if related invasive procedure required and is reportable (unlikely).
`80`	Assistant surgeon — Not applicable	Use only if another clinician assisted in an invasive procedure associated with specimen collection.
`AD`	Surgical assistant — Not applicable	Use only if an assistant was required for an associated procedure.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist service	Use when an advanced practice clinician independently orders and documents the test under applicable supervision rules.
`CO`	Temporary absence (services performed by a locum tenens)	Use when a locum tenens clinician ordered or interpreted the test.
`QK`	Clinical psychologist service — Not applicable	Use only if an unusual behavioral health component is documented (rare).
`TC`	Technical component	Use when reporting only the laboratory technical component (processing, assay, and report generation) without the professional interpretation.

Taxonomy Code	Specialty	Notes
`207RC0000X`	Allergy & Immunology	Specialists who commonly order and interpret peanut epitope assays.
`207L00000X`	Pediatric Allergy & Immunology	Pediatric specialists ordering testing for suspected food allergy in children.
`208D00000X`	Pediatrics	Primary care pediatricians who refer or order testing as part of evaluation.
`261QM1300X`	Clinical Laboratory	Laboratories and clinical pathologists performing the proprietary assay and reporting results.
`208000000X`	Family Medicine	Family physicians involved in allergy evaluation and management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z13.820`	Encounter for screening for other disorder	Used for screening evaluation in patients with suspected food allergy where testing is ordered.
`T78.01XA`	Anaphylactic reaction due to peanut, initial encounter	Relevant when confirming peanut allergy after a clinical reaction and supporting further management.
`T78.1XXA`	Other adverse food reactions, not elsewhere classified, initial encounter	Used for non-anaphylactic adverse reactions to foods when peanut allergy is in the differential.
`R21`	Rash and other nonspecific skin eruptions	Common presenting symptom prompting evaluation for food allergy including peanut.
`R06.02`	Shortness of breath	Respiratory symptoms that may accompany IgE-mediated food allergy and prompt diagnostic testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86003`	Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative; multiple step method, each specimen	May be used for supplemental allergen-specific IgE testing when standard immunoassays are ordered alongside the proprietary epitope assay.
`86140`	Immunoassay for allergen-specific IgE; quantitative	Commonly performed before or after epitope mapping to measure specific IgE to peanut components (e.g., Ara h proteins) as part of the allergy panel.
`36415`	Collection of venous blood by venipuncture	The phlebotomy code used for blood specimen collection required to perform the `0165U` assay.
`82784`	Alpha-gal IgE (Galactose-alpha-1,3-galactose)	Occasionally ordered in differential evaluation of food allergy presentations to assess for non-peanut carbohydrate-related allergy; may be part of broader workup.
`99000`	Handling and/or conveyance of specimen for transfer from provider to laboratory	Used when specific specimen handling or courier services are separately billable in certain contexts.

CPT 0001U: PreciseType HEA Multiplex Erythrocyte Antigen Assay

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: Urine Metabolomic Polyp Risk Assay (PolypDX™)

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa™ (OVA1 Next Generation) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) Urine Gene Expression Risk 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 Panel, Gene Sequence Analysis

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: Cordant CORE™ 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 Transcript Testing

Showing 1–10 of 536

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 0165U: VeriMAP Peanut Epitope Assay, Blood Immunoassay Profile

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Billing Code Overview

OpenPayer

CPT 0165U: VeriMAP Peanut Epitope Assay, Blood Immunoassay Profile

Sign up for cpt 0165U policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References