Summary & Overview
CPT 0181U: Navigator CO Sequencing for Colton Blood Group Antigens
CPT code 0181U is a Proprietary Laboratory Analyses (PLA) code for the Navigator CO Sequencing test from Grifols Immunohematology Center that sequences genes related to Colton (CO) blood group antigens. This molecular assay identifies antigen status to help clinicians reduce the risk of transfusion, transplant, and peripartum incompatibility reactions. As a PLA code, 0181U applies to a single manufacturer’s test and is specific to the Grifols product, which has implications for coverage, coding clarity, and payer contracting.
Key payers in typical national coverage discussions include Aetna, Blue Cross Blue Shield plans, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for antigen genotyping, how a PLA code may affect coding and billing workflows, and what to expect in payer discussions. The publication summarizes benchmark considerations, relevant policy themes for proprietary tests (including single-source coding and laboratory reporting), and clinical circumstances where CO antigen determination is relevant, such as transfusion planning, organ transplant compatibility assessment, and management in pregnancy and newborns.
Data not available in the input: specific payer coverage policies, associated ICD-10 codes, related billing codes, and detailed taxonomies. The report focuses on national implications and practical coding context for CPT code 0181U.
Billing Code Overview
CPT code 0181U is a Proprietary Laboratory Analyses (PLA) code for the Navigator CO Sequencing test from Grifols Immunohematology Center. The test analyzes specific gene sequences associated with the Colton (CO) blood group antigens to identify antigen status. Results can inform clinical decisions to minimize adverse blood–type incompatibility reactions in blood transfusions, organ transplants, and in pregnancy and newborn care.
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Service type: Molecular genetic sequencing assay targeting Colton blood group antigen determination
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Typical site of service: Clinical laboratory or reference laboratory using a blood specimen
Clinical & Coding Specifications
Clinical Context
A transfusion medicine specialist or immunohematology laboratory receives a blood specimen from a pregnant woman with a history of alloimmunization or from a patient scheduled for blood transfusion or organ transplant. The clinician orders the Navigator CO Sequencing test to determine Colton blood group antigen genotype by sequencing the specific gene regions identified by Grifols Immunohematology Center. The laboratory performs DNA extraction from the blood specimen, runs the proprietary sequencing assay, and generates a report indicating Colton (CO) antigen genotype (e.g., CO01, CO02, or variant alleles). Results are used by transfusion medicine physicians, obstetricians, neonatologists, or transplant teams to guide selection of antigen-compatible donor blood, manage hemolytic disease of the fetus and newborn risk, and reduce risk of transfusion or transplant incompatibility. Typical workflow steps: order entry by clinician, specimen collection and shipment to the performing laboratory, receipt and accessioning, DNA-based sequencing assay run under the proprietary PLA method, result interpretation and report distribution to the ordering clinician, and documentation in the patient record prior to transfusion or transplant planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing separate professional interpretation for the test if split billing applies |
TC | Technical component | When billing only the technical component (laboratory processing) of the test |
59 | Distinct procedural service | Data not available in the input. |
QX | Ordering physician NPI reporting modifier | When the test is performed under a CLIA-certified lab using a specific personnel arrangement (use per payer requirements) |
QY | Ordering, performing provider linkage | When an independent laboratory performs a test ordered by another provider and linkage is required (per payer rules) |
AD | Advanced beneficiary notice exception | When specific contractual billing requirements apply (use per payer rules) |
CO | Contractual obligation | When payer adjustments are applied due to contractual agreements |
FY | Laboratory test performed by a qualified non-physician | When applicable personnel distinctions are required by payer |
SH | Medically supervised anesthesiology | Data not available in the input. |
SJ | Clinical trial modifier | When the test is performed as part of an approved clinical trial |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RH0000X | Pathology (Clinical Pathology) | Clinical laboratories performing molecular blood group testing |
| 207L00000X | Hematology | Hematologists who manage transfusion and alloimmunization |
| 207P00000X | Pathology (Transfusion Medicine) | Specialists overseeing immunohematology testing and transfusion decisions |
| 207K00000X | Medical Genetics | Clinical geneticists or molecular diagnostics specialists interpreting genotype results |
| 208D00000X | Obstetrics & Gynecology | Ordering clinicians in pregnancy management for alloimmunization |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
D75.8 | Other specified diseases of blood and blood-forming organs | Used for specific hemolytic or alloimmune blood disorders requiring antigen genotyping |
D59.0 | Drug-induced autoimmune hemolytic anemia | Hemolysis evaluation may include extended antigen genotyping including Colton |
D59.1 | Other autoimmune hemolytic anemias | Workup of hemolysis can include molecular blood group testing |
O36.0XX0 | Maternal care for isoimmunization, unspecified trimester, fetus 0 | Obstetric code for alloimmunized pregnancy where fetal/newborn risk assessment includes Colton genotyping |
Z51.0 | Encounter for antineoplastic radiation therapy | Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
86900 | Antibody identification; complete panel, each patient | Performed in immunohematology labs to identify clinically significant alloantibodies that may prompt Colton genotyping |
86850 | Blood typing; ABO, Rh(D) group | Standard serologic typing performed as part of pre-transfusion testing prior to molecular Colton sequencing |
86820 | Antibody screen, each patient | Initial screen for unexpected antibodies that can trigger extended antigen genotyping |
81479 | Unlisted molecular pathology procedure | Occasionally used for reporting novel or proprietary molecular tests when PLA codes are not available (administrative alternative) |
G0480 | Molecular pathology test; level 1 (Medicare G-code) | Example Medicare molecular pathology reporting that may be associated in broader molecular testing panels |