CPT 0185U: Navigator FUT1 Sequencing for H Blood Group Antigen Analysis - OpenPayer

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Summary & Overview

CPT 0185U: Navigator FUT1 Sequencing for H Blood Group Antigen Analysis

CPT code 0185U designates the Navigator FUT1 Sequencing proprietary laboratory test developed by Grifols Immunohematology Center that sequences genes affecting H blood group antigens. This specialized genetic sequencing test is clinically relevant for reducing adverse blood–type incompatibility events in transfusions, organ transplants, and perinatal care by identifying variant alleles that alter antigen expression. Nationally, PLA codes like 0185U are important for payer coverage decisions because they represent manufacturer- or lab-specific assays with potentially limited clinical adoption and variable reimbursement.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the test, the typical sites of service (clinical laboratories and specialized immunohematology centers), and the policy and coverage considerations that commonly affect proprietary genetic assays. The publication covers benchmarking of coverage status across major payers, summaries of pertinent policy language and coding guidance, and clinical context that frames use cases for transfusion medicine, transplantation compatibility, and obstetric/newborn care. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0185UCPTProprietary Laboratory AnalysesGenetic SequencingImmunohematologyBlood TransfusionH Blood GroupLaboratory Medicine

Billing Code Overview

CPT code 0185U is a Proprietary Laboratory Analyses (PLA) code for the Navigator FUT1 Sequencing test from Grifols Immunohematology Center. The test analyzes specific gene sequences affecting H blood group antigens to help clinicians identify genetic variations that may contribute to blood–type incompatibility reactions.

Service type: Genetic sequencing for blood group antigen analysis

Typical site of service: Clinical laboratory or specialized immunohematology center

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A 32-year-old pregnant woman with a prior history of transfusion reactions is referred by her obstetrician for molecular blood group testing to assess risk of H antigen–related incompatibility. A sample of peripheral blood is collected and sent to the Grifols Immunohematology Center for the Navigator FUT1 Sequencing test reported with 0185U. The laboratory performs targeted sequencing of the FUT1 gene regions described by the PLA code to identify variants affecting H blood group antigen expression. Results are returned to the ordering clinician and transfusion medicine team to guide selection of compatible donor blood or organ transplant planning, and to inform perinatal risk assessment for the fetus and newborn. Typical workflow steps include clinician order entry, specimen collection and labeling, courier transport to the reference lab, sequencing and variant interpretation by the performing laboratory, electronic report delivery to the ordering provider, and documentation of results in the patient’s medical record for transfusion or obstetric management decisions.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional/interpretive component of the test if the performing laboratory separates technical and professional components and a reporting physician bills separately.

Taxonomy Code	Specialty	Notes
`207RC0000X`	Clinical Molecular Genetics Laboratory	Laboratory specialty performing molecular sequencing assays such as FUT1 testing.
`207RH0004X`	Clinical Pathology	Pathologists directing immunohematology and molecular laboratory operations.
`208000000X`	Transfusion Medicine	Specialists ordering and interpreting blood group molecular testing for transfusion compatibility.
`207L00000X`	Obstetrics & Gynecology	Obstetricians ordering testing for maternal-fetal H antigen risk assessment.
`261QM0800X`	Pediatric Hematology-Oncology	Pediatric specialists using results for newborn transfusion planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`O36.5930`	Maternal care for other fetal problems, third trimester, unspecified fetus	Used when maternal-fetal antigen incompatibility is a concern in pregnancy and sequencing is performed to assess fetal risk.
`D75.81`	Other platelet function defects	Represents hematologic disorders where transfusion planning and antigen matching may be required; molecular blood group data can inform transfusion strategy.
`Z51.0`	Encounter for antineoplastic radiation therapy	Data not available in the input.
`Z31.89`	Encounter for other procreative management	Used for prenatal planning when parental blood-group genetics are assessed.
`T88.1XXA`	Other complications following infusion, initial encounter	Used when a patient has a history of transfusion reaction prompting molecular testing to prevent recurrence.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81025`	Urinalysis, automated, with microscopy	Ancillary lab test that may be ordered during prenatal or pre-transfusion evaluation; not specific to FUT1 sequencing.
`86318`	Immunohematology testing; antibody identification, each panel	Serologic testing commonly performed alongside molecular blood group testing to assess antibodies and phenotyping.
`86900`	Crossmatch, serologic	Compatibility testing performed before transfusion; molecular results inform selection of compatible donor blood.
`81479`	Unlisted molecular pathology procedure	Sometimes used for custom molecular tests when a PLA code is not available; `0185U` is a PLA code specific to the Navigator FUT1 Sequencing test and replaces the need for `81479` for this proprietary assay.
`88235`	Clonal analysis, molecular cytogenetics, fluorescence in situ hybridization (FISH)	Unrelated to FUT1 sequencing; listed here as a lab molecular technique sometimes used in broader transfusion/hematology workflows.