Summary & Overview
CPT 0186U: FUT2 Sequencing for H Antigen Secretor Status
CPT code 0186U is a Proprietary Laboratory Analyses (PLA) code that identifies the Navigator FUT2 Sequencing test from Grifols Immunohematology Center, a targeted genetic sequencing assay for FUT2 gene variants that influence H antigen presence in secretions. This test has clinical relevance for immunohematology by clarifying secretor status and reducing the risk of blood-type incompatibility in transfusion, transplantation, and perinatal care. Nationally, PLA codes like 0186U matter because they enable tracking and billing for single-manufacturer or single-laboratory molecular tests that have specific clinical utility.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the test, the typical site of service, and which payers are considered. The publication outlines what users can expect to learn: how the code is defined, where the test is performed, common billing modifiers associated with the service, and available input data. It also highlights limitations where input data are absent and directs readers to the clinical implications of FUT2 sequencing in transfusion and perinatal settings. Data not available in the input are noted where relevant.
Billing Code Overview
CPT code 0186U is a Proprietary Laboratory Analyses (PLA) code for the Navigator FUT2 Sequencing test from Grifols Immunohematology Center. The assay sequences specific regions of the FUT2 gene to characterize variants that affect H blood group antigens, particularly the H antigen present in secretions such as saliva. Results can inform immunohematology interpretation to help minimize adverse blood–type incompatibility reactions in blood transfusion, organ transplantation, and management of pregnant patients and newborns.
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Service type: Genetic sequencing laboratory test focused on FUT2 gene analysis for H antigen secretion status
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Typical site of service: Clinical laboratory (specimen sources include blood or saliva)
Clinical & Coding Specifications
Clinical Context
A 32-year-old pregnant woman with a history of multiple prior transfusions presents for prenatal care after her first-trimester visit. Her obstetric team requests additional immunohematology evaluation because of discrepant ABO/Rh serology and concern for weak or variant H antigen expression that can affect secretor status and blood-group compatibility in transfusion and perinatal management. A specimen of blood or saliva is collected and sent to a reference laboratory where the proprietary Navigator FUT2 Sequencing test (0186U) from Grifols Immunohematology Center is performed. The laboratory extracts DNA, sequences the specified FUT2 gene regions, and reports FUT2 genotype and predicted secretor phenotype. Results are used by transfusion medicine and obstetrics teams to clarify antigen expression in secretions, aid in blood product selection, minimize transfusion incompatibility risk, and inform neonatal risk assessment for hemolytic disease of the fetus and newborn.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation/reporting portion of the test separate from technical processing. |
TC | Technical component | Use when billing only the laboratory technical component (performed by the lab) without professional interpretation. |
QY | Laboratory test provided by independent laboratory under PAMA rules | Use when applicable to identify tests furnished under qualified laboratory arrangements (carrier-specific usage). |
QX | Ordering supplier certification (CLIA) | Use to indicate the ordering physician or supplier meets CLIA requirements when applicable. |
AD | Anesthesia service unrelated (not typically used for PLAs) | Rare; not applicable for routine lab testing but available if billing contexts require it. |
59 | Distinct procedural service (Note: not in provided list) | Data not available in the input. |
82 | Assistant surgeon (when a lesser trained assistant is used) | Data not available in the input. |
11 | Diagnostic service, perhaps initial encounter (facility-specific) | Use when indicating a standard, primary diagnostic laboratory service performed as ordered. |
52 | Reduced services | Use when the test was partially performed or substantially reduced from standard protocol. |
90 | Reference laboratory outside entity (Note: not in provided list) | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207Q00000X | Transfusion Medicine | Physicians who interpret immunohematology and compatibility testing. |
| 207R00000X | Clinical Pathology | Pathologists overseeing laboratory testing and quality for specialized assays. |
| 208000000X | Obstetrics & Gynecology | OB clinicians ordering FUT2 sequencing for perinatal risk assessment and transfusion planning. |
| 207L00000X | Hematology | Hematologists involved in complex transfusion management and interpretation of blood-group genetics. |
| 363A00000X | Clinical Laboratory Technician | Laboratory professionals performing the technical sequencing and specimen processing. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
O36.5XX0 | Maternal care for other suspected fetal problems, unspecified trimester | Used when investigating potential fetal hemolytic risk related to maternal blood-group variants affecting secretions. |
Z39.2 | Encounter for routine postpartum follow-up | May be used when postpartum transfusion planning or neonatal assessment involves maternal secretor status. |
Z51.89 | Encounter for other specified aftercare | Applied when follow-up care includes interpretation of specialized immunohematology testing results. |
D75.9 | Hematological disorder, unspecified | Used when a patient has atypical red cell antigen expression requiring molecular evaluation. |
Z34.90 | Encounter for supervision of normal pregnancy, unspecified trimester | Routine prenatal visits where additional testing like FUT2 sequencing is ordered for risk stratification. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
81479 | Unlisted molecular pathology procedure | Used when additional or custom molecular analyses related to FUT2 are required that are not captured by a PLA code. |
87491 | Infectious agent detection by nucleic acid (e.g., single target) | Not directly the same methodology but represents nucleic acid detection workflows that laboratories commonly perform alongside sequencing workflows for sample handling; used here as a related molecular technique code category. |
81025 | Urinalysis non-automated, without microscopy | Data not available in the input. |
36415 | Collection of venous blood by venipuncture | Common preanalytic service performed to obtain the blood specimen sent for the FUT2 sequencing test. |
0232U | Other PLA test (example PLA code) | Represents that other PLA codes may be billed for different proprietary immunohematology assays performed by the same laboratory or as complementary tests in compatibility workups. |