Summary & Overview
CPT 0187U: Duffy Blood Group Sequencing (Navigator FY)
CPT code 0187U designates a proprietary laboratory sequencing test — the Navigator FY Sequencing assay from Grifols Immunohematology Center — that identifies Duffy blood group antigen genotypes from a blood specimen. This molecular diagnostic aids clinicians in minimizing adverse blood‑type incompatibility reactions relevant to blood transfusion, organ transplantation, and maternal–newborn care. As a PLA code, 0187U maps to a single manufacturer‑specific test and is used when reporting this unique assay.
Key payers addressed in typical coverage analyses include Aetna, Blue Cross Blue Shield plans, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of clinical utility and test context, an overview of payer coverage considerations, and benchmarking of how proprietary molecular assays are treated in reimbursement policy nationally. The publication also summarizes common billing modifiers and practical coding notes for reporting the technical and professional components, and it highlights where input was not provided (for example, specific ICD‑10 diagnoses and associated taxonomies). This resource is intended to inform billing, clinical, and policy stakeholders about the role of CPT code 0187U in genetic immunohematology testing and the payer landscape relevant to national practice.
Billing Code Overview
CPT code 0187U is a Proprietary Laboratory Analyses (PLA) code for the Navigator FY Sequencing test from Grifols Immunohematology Center. The test analyzes specific gene sequences related to the Duffy blood group antigens, which can inform transfusion, transplantation, and perinatal compatibility decisions.
Service type: Genetic sequencing / molecular diagnostic assay performed on a blood specimen.
Typical site of service: Clinical laboratory or specialized immunohematology reference laboratory performing molecular diagnostic testing.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A 32-year-old pregnant woman with a history of multiple transfusions in prior surgeries is scheduled for prenatal care and blood typing to reduce the risk of hemolytic disease of the newborn and transfusion reactions. Her obstetrician orders the Navigator FY Sequencing test from Grifols Immunohematology Center to determine Duffy blood group antigen genotypes from a blood specimen. The clinical workflow: the clinician collects a peripheral blood sample, labels and ships it per the laboratory’s specimen requirements. The reference lab performs targeted sequencing of the Duffy (FY) gene regions specified by the proprietary test, interprets genotype to predict Duffy antigen expression, and returns a report indicating antigen status. The results are reviewed by the obstetrician and transfusion medicine or blood bank consult when needed to guide selection of compatible red blood cell units for transfusion, manage antenatal antibody surveillance, and plan peripartum care for the newborn regarding potential hemolytic risk.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no special circumstances or component distinctions apply. |
11 | Office or other outpatient service component | Use when reporting the default professional service in line with payer rules. |
26 | Professional component | Use when billing only the professional interpretation portion if split billing applies. |
TC | Technical component | Use when billing only the technical component (laboratory processing) of the test. |
91 | Repeat clinical diagnostic laboratory test | Use when an identical test is repeated on the same patient to confirm results. |
QX | Ordering physician certified lab test performer modifier | Use when the lab test is performed by the ordering provider who also performs the test under applicable rules. |
QY | Laboratory test performed by independent laboratory under order from another provider | Use when an independent laboratory performs the test under an order from the treating provider. |
AD | Anesthesia-related modifier (distinct) | Rarely used; apply only if anesthesia-related circumstances alter billing context per payer policy. |
52 | Reduced services | Use when the test or service was partially reduced or not completed as originally planned. |
53 | Discontinued service | Use when the specimen or test could not be completed and was discontinued. |
78 | Unplanned return to the operating/procedure room | Not commonly applicable; use if test-related procedures required an unplanned return for management. |
80 | Assistant at surgery | Not typically applicable for this laboratory test; use only when surgical assistant billing is relevant. |
91 | Repeat testing for quality control or verification | Use when documentation supports repeat testing for verification (note: 91 already listed to emphasize lab repeat use). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207Q00000X | Pathology & Laboratory Medicine | Clinical pathologists and laboratory directors who oversee molecular immunohematology testing. |
| 207L00000X | Hematology | Hematologists involved in transfusion medicine and blood group interpretation. |
| 207K00000X | Transfusion Medicine | Specialists in blood banking who use genotyping results to manage transfusion compatibility. |
| 207P00000X | Obstetrics & Gynecology | Obstetricians ordering the test for pregnant patients at risk for hemolytic disease of the newborn. |
| 207RP1001X | Molecular Genetic Pathology | Laboratory physicians or molecular geneticists who interpret sequencing-based blood group assays. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
O36.0XX0 | Maternal care for known or suspected fetal abnormality and damage, unspecified, first trimester | Duffy genotyping may be ordered in pregnancy when fetal or maternal alloimmunization risk is a concern. |
O36.0XX1 | Maternal care for known or suspected fetal abnormality and damage, first trimester, fetus 1 | Similar relevance for antenatal planning and antibody surveillance. |
D75.8 | Other specified disorders of blood and blood-forming organs | Used when investigating atypical blood group or hemolytic conditions where genotyping informs diagnosis. |
Z51.3 | Encounter for blood transfusion | Duffy genotyping can guide selection of compatible blood units for transfusion. |
Z61.5 | Chronic hemolytic anemia, unspecified | Genotyping can assist in determining antigen mismatches contributing to hemolysis. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36415 | Collection of venous blood by venipuncture | Often performed prior to sending specimen to the reference lab for the Navigator FY Sequencing test. |
86765 | Antibody identification; red blood cell antibody testing | Performed alongside genotyping when antibody screens are positive to correlate phenotype and antibody specificity. |
86900 | Blood typing; ABO | Performed as part of routine blood bank workup before or concurrent with genotypic testing. |
86901 | Rh typing (D) | Performed in serologic testing; genotyping provides additional antigen resolution beyond serology. |
88305 | Level IV surgical pathology, gross and microscopic examination (analogous service) | Not directly for this molecular test but sometimes billed by labs for interpretive report components; verify payer policy. |
81479 | Unlisted molecular pathology procedure | Used rarely when a specific PLA code is not recognized by a payer; for this test 0187U is the proper PLA code. |