Summary & Overview

CPT 0190U: Navigator GYPB Sequencing for MNS Blood Group Antigens

CPT code 0190U designates a Proprietary Laboratory Analyses (PLA) test — the Navigator GYPB Sequencing assay from Grifols Immunohematology Center — which sequences gene regions to identify MNS blood group antigens. This molecular blood-typing test is clinically relevant for reducing risk of transfusion reactions, guiding organ transplant compatibility decisions, and informing obstetric and neonatal care where blood-group incompatibility is a concern. Nationally, PLA codes like 0190U matter because they represent manufacturer- or lab-specific tests that may have unique clinical utility but variable coverage and coding guidance across payers.

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 code’s clinical purpose, how the test is typically performed and where, plus coverage and billing considerations commonly associated with PLA codes. The publication summarizes benchmarking and coverage patterns, highlights policy and coding updates relevant to proprietary molecular assays, and provides clinical context for when MNS antigen genotyping is used. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0190UCPTProprietary Laboratory AnalysesMNS blood groupgenetic sequencingtransfusion medicineimmunohematologylaboratory testing

Billing Code Overview

CPT code 0190U is a Proprietary Laboratory Analyses (PLA) code for the Navigator GYPB Sequencing test from Grifols Immunohematology Center. The test analyzes specific gene sequences to determine MNS blood group antigens, which can help clinicians minimize adverse blood–type incompatibility reactions in blood transfusions, organ transplants, and in pregnancy and newborns.

Service type: Genetic sequencing analysis of blood group antigen genes
Typical site of service: Clinical laboratory using a blood specimen

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult or neonatal patient requiring extended red blood cell antigen characterization to guide transfusion, transplant, or perinatal management. For example, a pregnant woman with an antibody screen showing possible anti-M or unclear MNS system antibodies, or a patient with a history of multiple transfusions and complex serologic typing, has a blood sample sent to Grifols Immunohematology Center for the Navigator GYPB Sequencing test. The clinical workflow: a clinician or transfusion medicine specialist orders the test in the electronic medical record, phlebotomy collects a peripheral blood specimen, the specimen is shipped under chain-of-custody to the reference lab, and the lab performs targeted sequencing of the GYPB gene to predict MNS blood group antigen expression. Results report antigen genotype/alleles and interpretive guidance; the transfusion service uses them to select compatible blood products, and obstetrics uses results to assess fetal/neonatal alloimmunization risk.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional component of interpretation, if separated from the technical lab work.
`TC`	Technical component	Use when billing only the technical component (laboratory processing) of the test.
`59` is not in the provided list and must not be used.	Data not applicable.	Data not applicable.
`22`	Increased procedural services	Use when work required is substantially greater than typical (rare for a PLA but may apply if extensive reporting required).
`52`	Reduced services	Use if the test is partially performed or limited by specimen quality or incomplete analysis.
`53`	Discontinued procedure	Use if testing was started but discontinued for documented clinical reasons.
`80`	Assistant surgeon	Not typically applicable to laboratory testing; included in list but rarely used for this service.
`62`	Two surgeons	Not typically applicable to laboratory testing; included for completeness when surgical context overlaps.
`AD`	Mobility assist device	Use when special handling/shipping is required for a patient with a disability impacting specimen collection logistics.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist service	Use when a qualifying non-physician practitioner orders and is billing under their practitioner number per payer rules.
`QK`	Medical direction of two, three, or four CNPs/physician assistants	Use when applicable under medical direction billing scenarios for ordering providers.

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology	Transfusion medicine and hemolytic disease specialists who order and interpret blood group genotyping.
2080P0207X	Pathology	Blood bank / immunohematology laboratory directors overseeing molecular blood group testing.
208100000X	Clinical Laboratory	Clinical laboratory professionals and molecular diagnostics labs that perform the sequencing assay.
363L00000X	Obstetrics & Gynecology	Maternal–fetal medicine and obstetricians who order testing for alloimmunized pregnancies.
207L00000X	Internal Medicine	Hospitalists or internists managing transfusion-dependent patients and ordering antigen genotyping.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D67`	Hereditary factor VIII deficiency (Hemophilia A)	Patients with bleeding disorders may have transfusion needs; extended antigen genotyping guides compatible transfusions.
`Z34.00`	Encounter for supervision of normal first pregnancy, unspecified trimester	Obstetric patients undergoing alloimmunization risk assessment may require molecular antigen typing.
`O36.592`	Maternal care for anti-D antibodies, second trimester	Maternal alloantibodies to red cell antigens prompt molecular testing to determine fetal risk and donor selection.
`Z51.11`	Encounter for antineoplastic chemotherapy	Chronically transfused oncology patients may develop alloantibodies; genotyping informs product selection.
`D62`	Acute posthemorrhagic anemia	Patients requiring urgent transfusion may benefit from antigen genotyping when history suggests alloimmunization.
`Z51.89`	Encounter for other specified aftercare	Post-transfusion follow-up or complex transfusion planning can involve molecular blood group testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Specimen collection step prior to sending blood for the Navigator GYPB Sequencing test.
`86346`	Blood typing; ABO	Performed in the transfusion workup alongside molecular testing to provide serologic phenotype context.
`86850`	Antibody screen, RBC antibody (indirect antiglobulin test)	Initial screen that often triggers reflex molecular genotyping when results are atypical or complex.
`81479`	Unlisted molecular pathology procedure	Occasionally used for reporting supplemental molecular analyses not covered by the PLA, but coding should defer to the PLA `0190U` for the specific Navigator GYPB Sequencing test.
`88262`	Interpretation and reporting of molecular pathology test (if applicable)	Professional interpretation reporting associated with complex molecular blood group results; bill when a separate interpretation service is provided.

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Summary & Overview

CPT 0190U: Navigator GYPB Sequencing for MNS Blood Group Antigens

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0190UCPTProprietary Laboratory AnalysesMNS blood groupgenetic sequencingtransfusion medicineimmunohematologylaboratory testing

Billing Code Overview

Service type: Genetic sequencing analysis of blood group antigen genes
Typical site of service: Clinical laboratory using a blood specimen

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional component of interpretation, if separated from the technical lab work.
`TC`	Technical component	Use when billing only the technical component (laboratory processing) of the test.
`59` is not in the provided list and must not be used.	Data not applicable.	Data not applicable.
`22`	Increased procedural services	Use when work required is substantially greater than typical (rare for a PLA but may apply if extensive reporting required).
`52`	Reduced services	Use if the test is partially performed or limited by specimen quality or incomplete analysis.
`53`	Discontinued procedure	Use if testing was started but discontinued for documented clinical reasons.
`80`	Assistant surgeon	Not typically applicable to laboratory testing; included in list but rarely used for this service.
`62`	Two surgeons	Not typically applicable to laboratory testing; included for completeness when surgical context overlaps.
`AD`	Mobility assist device	Use when special handling/shipping is required for a patient with a disability impacting specimen collection logistics.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist service	Use when a qualifying non-physician practitioner orders and is billing under their practitioner number per payer rules.
`QK`	Medical direction of two, three, or four CNPs/physician assistants	Use when applicable under medical direction billing scenarios for ordering providers.

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology	Transfusion medicine and hemolytic disease specialists who order and interpret blood group genotyping.
2080P0207X	Pathology	Blood bank / immunohematology laboratory directors overseeing molecular blood group testing.
208100000X	Clinical Laboratory	Clinical laboratory professionals and molecular diagnostics labs that perform the sequencing assay.
363L00000X	Obstetrics & Gynecology	Maternal–fetal medicine and obstetricians who order testing for alloimmunized pregnancies.
207L00000X	Internal Medicine	Hospitalists or internists managing transfusion-dependent patients and ordering antigen genotyping.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D67`	Hereditary factor VIII deficiency (Hemophilia A)	Patients with bleeding disorders may have transfusion needs; extended antigen genotyping guides compatible transfusions.
`Z34.00`	Encounter for supervision of normal first pregnancy, unspecified trimester	Obstetric patients undergoing alloimmunization risk assessment may require molecular antigen typing.
`O36.592`	Maternal care for anti-D antibodies, second trimester	Maternal alloantibodies to red cell antigens prompt molecular testing to determine fetal risk and donor selection.
`Z51.11`	Encounter for antineoplastic chemotherapy	Chronically transfused oncology patients may develop alloantibodies; genotyping informs product selection.
`D62`	Acute posthemorrhagic anemia	Patients requiring urgent transfusion may benefit from antigen genotyping when history suggests alloimmunization.
`Z51.89`	Encounter for other specified aftercare	Post-transfusion follow-up or complex transfusion planning can involve molecular blood group testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Specimen collection step prior to sending blood for the Navigator GYPB Sequencing test.
`86346`	Blood typing; ABO	Performed in the transfusion workup alongside molecular testing to provide serologic phenotype context.
`86850`	Antibody screen, RBC antibody (indirect antiglobulin test)	Initial screen that often triggers reflex molecular genotyping when results are atypical or complex.
`81479`	Unlisted molecular pathology procedure	Occasionally used for reporting supplemental molecular analyses not covered by the PLA, but coding should defer to the PLA `0190U` for the specific Navigator GYPB Sequencing test.
`88262`	Interpretation and reporting of molecular pathology test (if applicable)	Professional interpretation reporting associated with complex molecular blood group results; bill when a separate interpretation service is provided.