Summary & Overview
CPT 0178U: VeriMAP Peanut Sensitivity Bead-Based Epitope Assay
CPT code 0178U designates a Proprietary Laboratory Analyses (PLA) test: the VeriMAP Peanut Sensitivity – Bead–based Epitope Assay from AllerGenis™ Clinical Laboratory. This specialized blood test maps patient-specific peanut protein epitopes using a bead–based microarray immunoassay and reports the minimum dose of peanut protein capable of triggering an allergic reaction in highly sensitized individuals. The code is significant nationally because it identifies a single-manufacturer diagnostic assay with potential implications for allergy management, laboratory billing, and coverage policy.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise account of what the code represents, the clinical context of epitope mapping for peanut allergy, and which major payers are part of the coverage landscape. The publication outlines expected service settings, common modifiers associated with lab billing, and notes where input data are not available for specific taxonomies, ICD-10 links, or related codes.
This summary prepares payers, billing professionals, and clinical laboratory managers to understand the test’s purpose, the coding designation as a PLA, and where to look for payer-specific coverage policies and reimbursement details.
Billing Code Overview
CPT code 0178U is a Proprietary Laboratory Analyses (PLA) code for the VeriMAP Peanut Sensitivity – Bead–based Epitope Assay from AllerGenis™ Clinical Laboratory. The test is a blood-based bead–based microarray immunoassay that maps patient epitopes (immunogenic antigens in food proteins) and reports the minimum dose of peanut protein capable of causing an allergic reaction in highly sensitized patients.
Service type: Laboratory diagnostic test (proprietary PLA assay)
Typical site of service: Clinical laboratory or outpatient phlebotomy collection site, with analytic processing performed by the manufacturer laboratory.
Clinical & Coding Specifications
Clinical Context
A pediatric or adult patient with a history of immediate-type allergic reactions to peanut exposure or with sensitization on prior testing presents for advanced risk stratification. The treating allergist or immunologist orders the VeriMAP Peanut Sensitivity – Bead–based Epitope Assay (0178U) to map IgE-binding epitopes to peanut proteins and to estimate the minimum eliciting dose in highly sensitized patients. Typical clinical workflow: the clinician documents history of allergic reactions, prior skin or serum testing results, and rationale for epitope mapping (for example, discordant clinical history and standard testing or consideration of desensitization). A venous blood specimen is collected in an appropriate tube at an outpatient clinic, specialty allergy office, or hospital outpatient laboratory. The sample is sent to AllerGenis™ Clinical Laboratory for bead–based microarray immunoassay. Results are returned to the ordering clinician and integrated into the allergy management plan, which may include avoidance counseling, prescription of emergency medications (epinephrine autoinjector), consideration of oral immunotherapy or supervised food challenge planning. Typical site of service: outpatient specialty clinic (allergy/immunology) or outpatient laboratory; specimen collection may occur in hospital outpatient clinics. Service type: Proprietary Laboratory Analysis (PLA) — specialized diagnostic laboratory test performed by a single manufacturer/laboratory.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no specific modifier applies and services are billed as usual. |
26 | Professional component | Use when billing only the professional interpretation component separate from the technical/laboratory component. |
TC | Technical component | Use when billing only the technical component (laboratory processing, supplies) without professional interpretation. |
52 | Reduced service | Use when the test was partially performed or limited relative to the full procedure. |
53 | Discontinued procedure | Use when specimen collection or testing was started but discontinued for documented medical reasons. |
59 | Data not provided in input | Data not available in the input. |
QK | Ordering physician NPI on lab report | Use when the ordering provider's NPI is listed on the laboratory report (as required by some payors for PLA codes). |
QX | CLIA-qualified laboratory personnel | Use when a CLIA-qualified individual performed or supervised the laboratory testing per payer policy. |
QY | Medical direction of 2–4 services | Use when the billing physician medically directed multiple qualified individuals for lab services where applicable. |
AD | Regional anesthesia - data not applicable | Data not applicable to this procedure; not typically used. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RC0000X | Allergy and Immunology | Most common specialty ordering and interpreting the test. |
| 207RP1001X | Pediatric Allergy/Immunology | Pediatric subspecialists ordering testing for children with suspected peanut allergy. |
| 207RN0500X | Clinical Immunology | Specialists involved in complex immune evaluation and interpretation. |
| 208000000X | Family Medicine | May order testing when managing allergic patients in primary care prior to specialist referral. |
| 207L00000X | Pathology/Laboratory Medicine | Laboratory medicine oversight for processing and quality assurance. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
T78.01XA | Anaphylactic reaction due to peanuts, initial encounter | Indicates a history of severe allergic reaction to peanut prompting detailed sensitivity mapping. |
T78.01XD | Anaphylactic reaction due to peanuts, subsequent encounter | Used when follow-up evaluation includes advanced testing like 0178U. |
Z91.010 | Allergy to peanuts | Primary diagnosis to justify peanut-specific advanced diagnostic testing. |
J30.8 | Other allergic rhinitis | Comorbid atopic conditions that often coexist with food allergy and may prompt broader allergy evaluation. |
R21 | Rash and other nonspecific skin eruption | Skin manifestations associated with food allergy that may support the clinical rationale for testing. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36415 | Collection of venous blood by venipuncture | Performed immediately prior to 0178U for specimen acquisition. |
99000 | Handling and/or conveyance of specimen for transfer from physician's office to a laboratory | Used when specimen transport services are billed alongside specialized testing like 0178U. |
82785 | Alpha-gal IgE (serum) — example of allergen-specific IgE testing | Related serum-based immunologic assays that may be ordered in conjunction for broader allergy evaluation. |
86003 | Allergen specific IgE; quantitative or semi-quantitative, multiple allergens, each | Other allergen-specific IgE testing commonly ordered in the allergy workup; complements epitope mapping. |
99070 | Supplies and materials provided by physician over and above those usually included with the service | May apply if additional specialized collection materials are used for 0178U. |