Summary & Overview
CPT 0184U: Navigator DO Sequencing for Dombrock Blood Group Typing
CPT code 0184U designates a Proprietary Laboratory Analyses (PLA) test — the Navigator DO Sequencing assay from Grifols Immunohematology Center — that sequences specific genes to identify Dombrock (DO) blood group antigens. This molecular diagnostic has national relevance for transfusion medicine, transplant compatibility assessment, and perinatal care because DO antigen typing can reduce the risk of immune-mediated transfusion reactions and hemolytic disease in newborns. Major national payers included in this discussion are Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical purpose, the typical service setting (clinical/reference laboratory using a blood specimen), and the kinds of information payers consider when covering PLA molecular assays. The publication also summarizes available benchmarks and policy context where provided, highlights clinical implications for blood bank and transplant workflows, and notes any identified coverage or coding considerations. Data not available in the input will be identified as such rather than inferred.
Billing Code Overview
CPT code 0184U is a Proprietary Laboratory Analyses (PLA) code for the Navigator DO Sequencing test from Grifols Immunohematology Center. The test analyzes specific gene sequences to determine Dombrock (DO) blood group antigens, information that can help clinicians minimize adverse blood–type incompatibility reactions in blood transfusion, organ transplantation, and pregnancy/newborn care.
Service type: Laboratory molecular diagnostic test — targeted sequencing of DO blood group–related genes.
Typical site of service: Clinical laboratory or reference laboratory using a blood specimen.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient scheduled for pretransfusion compatibility testing or with a history of transfusion reactions, organ transplant evaluation, or prenatal/newborn hemolytic disease is referred for genotyping of Dombrock (DO) blood group antigens. A clinician (transfusion medicine specialist, obstetrician, neonatologist, or hematologist) orders the Navigator DO Sequencing test (0184U) when serologic typing is inconclusive, rare DO variants are suspected, or molecular antigen prediction is required to minimize alloimmunization risk. A peripheral blood specimen is collected in an EDTA tube and sent to the performing laboratory (Grifols Immunohematology Center). The lab performs targeted DNA sequencing of DO gene regions and reports DO antigen genotype and predicted phenotype. Results are used by blood bank staff and clinicians to select antigen-compatible blood products, guide transfusion planning, inform organ transplant matching, or evaluate fetal/newborn risk of hemolytic disease. Typical site of service: hospital laboratory, independent reference laboratory, or specialized transfusion medicine center. Service type: molecular diagnostic laboratory test (Proprietary Laboratory Analysis). Typical patient scenario: pregnant patient with an antibody to a high-prevalence DO antigen and discordant serology; or chronically transfused patient with multiple alloantibodies requiring molecular typing to identify compatible donor units.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the professional interpretation component of the test if the laboratory separates technical and professional components and the physician bill is submitted separately. |
TC | Technical component | When reporting only the laboratory's technical component (performed sequencing) for the performing laboratory claim. |
59 | Data not provided in the input. | Data not available in the input. |
22 | Increased procedural services | When work or resources exceed typical for the test (rare; documented extraordinary effort in analysis or interpretation). |
52 | Reduced services | If testing is partially performed or limited compared to the full test (e.g., limited gene region due to insufficient specimen). |
53 | Discontinued procedure | If specimen processing or testing is started but aborted for valid clinical reasons (e.g., specimen compromised). |
78 | Unplanned return to OR by same physician following prior procedure | Not applicable to lab testing but included in common modifier list; use only if clinically justified in a surgical context. |
80 | Assistant surgeon | Not applicable to this lab test; included for completeness when surgical services relate to transfusion procedures. |
QK | CLIA waived tests — device corrected tests | When specific laboratory workflow requires reporting an applicable QA/QC modifier per payer instruction (rare for PLA). |
QX | Ordering physician NPI and performing provider NPI — modifier indicating modifier combination for laboratory services | When the performing lab and ordering provider billing relationship requires specific reporting under payer rules. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RC0000X | Clinical & Transfusion Laboratory Medicine | Transfusion medicine specialists and laboratory directors overseeing molecular blood group testing. |
2080P3102X | Obstetrics & Gynecology | Ordering clinicians for prenatal alloimmunization evaluation. |
2080N0004X | Hematology & Oncology | Hematologists managing chronically transfused patients and alloimmunized individuals. |
207L00000X | Pathology | Pathologists directing laboratory testing and interpretation. |
208000000X | Pediatrics | Neonatologists and pediatricians ordering testing for newborn hemolytic disease risk. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
D68.9 | Disorder of blood and blood-forming organs, unspecified | May be used when specific hemolytic or alloimmune conditions are being evaluated pending more precise coding. |
Z51.89 | Encounter for other specified aftercare | Used for ongoing management related to transfusion or transplant follow-up when molecular typing informs care. |
O36.8XX0 | Maternal care for other specified fetal problems, unspecified trimester, not applicable or unspecified — Data not available in the input. | Data not available in the input. |
P55.0 | Hemolytic disease of newborn due to ABO incompatibility — Data not available in the input. | Data not available in the input. |
D56.9 | Thalassemia, unspecified | Chronic transfusion patients (e.g., thalassemia) often require extended molecular blood group typing to find compatible units. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36415 | Collection of venous blood by venipuncture | Commonly performed to obtain the EDTA blood specimen for the sequencing test. |
86355 | Specific antibody; not otherwise classified — Data not available in the input. | Data not available in the input. |
81162 | BRCA1 and BRCA2 (separate hereditary cancer testing) — Data not available in the input. | Data not available in the input. |
88141 | Cytopathology, smears — Data not available in the input. | Data not available in the input. |
0054U | Molecular blood group genotyping (example PLA) — Data not available in the input. | Data not available in the input. |