Summary & Overview

CPT 0192U: Navigator JK Sequencing for Kidd Blood Group Antigens

CPT code 0192U is a Proprietary Laboratory Analyses (PLA) code that identifies the Navigator JK Sequencing test from Grifols Immunohematology Center, a blood-based genetic sequencing assay for Kidd blood group antigens. The test has clinical relevance for transfusion medicine, transplant compatibility assessment, and perinatal care by clarifying antigen status that can reduce the risk of alloimmunization and hemolytic reactions. On a national level, PLA codes like 0192U matter because they represent single-source laboratory innovations that can affect clinical workflows, coding clarity, and payer coverage decisions.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the test, typical sites of service, and which major payers are considered in coverage discussions. The publication also outlines expected benchmarks and policy-relevant items readers should watch: how PLA coding shapes claims adjudication, implications for laboratory billing, and clinical contexts where the test may be ordered. Data not provided in the input—such as specific payer coverage policies, associated taxonomies, ICD-10 diagnoses, and related codes—are noted as unavailable. The content is intended to inform billing managers, laboratory directors, and clinicians about the code’s function and the payer landscape for this proprietary sequencing assay.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0192UCPTProprietary Laboratory AnalysesGenetic SequencingImmunohematologyKidd Blood GroupTransfusion MedicinePerinatal Testing

Billing Code Overview

CPT code 0192U is a Proprietary Laboratory Analyses (PLA) code for the Navigator JK Sequencing test from Grifols Immunohematology Center. The test analyzes specific gene sequences associated with the Kidd blood group system to identify Kidd antigens. Results can help clinicians minimize adverse blood–type incompatibility reactions in blood transfusions, organ transplants, and management of pregnancy and newborns.

Service type: Genetic sequencing for immunohematology (proprietary laboratory test)
Typical site of service: Clinical laboratory or specialized reference laboratory using a blood specimen

Clinical & Coding Specifications

Clinical Context

A recipient of blood transfusion, organ transplant candidate, or a pregnant person with a history of alloimmunization is referred for molecular blood group genotyping. The laboratory test is ordered by a transfusion medicine physician, obstetrician, or transplant coordinator when serologic typing is inconclusive, when rare Kidd (Jk) antigen variants are suspected, or when antibody identification or prenatal risk assessment requires genetic confirmation. A blood sample (EDTA whole blood) is collected in the outpatient clinic, hospital ward, or transfusion service and sent to the reference laboratory (Grifols Immunohematology Center). The laboratory performs the Navigator JK Sequencing assay to analyze specific SLC14A1 gene sequences that determine Kidd blood group antigens. Results reporting includes predicted Jk antigen expression to guide selection of compatible blood units, organ allocation decisions, or prenatal/newborn risk management. Turnaround time and electronic reporting follow the laboratory’s usual workflow for proprietary molecular assays; billing uses PLA code 0192U with the specimen and testing location documented in the laboratory report.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When only the physician’s interpretation or report is billed separately from the laboratory technical component.
`TC`	Technical component	When billing only the laboratory technical portion of the test (equipment, reagents, personnel) and a separate professional component is reported by a physician.
`90`	Reference (outside) laboratory	When the performing laboratory is different from the billing laboratory or when specimens are sent to an outside reference lab.
`62`	Two surgeons	Not typically used for laboratory tests; include only if two independent providers share professional responsibilities for interpretation.
`52`	Reduced services	When the test was partially performed or limited due to specimen quality or other constraints.
`53`	Discontinued service	If testing was started but discontinued for clinical or technical reasons prior to completion.
`59`	Distinct procedural service	When multiple unrelated services are billed on the same day and documentation supports distinct services (rare for a single PLA test).
`AD`	Advanced beneficiary notice waived	Use per payer rules when beneficiary has waived ABN requirements (payer-specific reporting).
`QW`	CLIA waived test	Not applicable to this complex molecular assay; do not use unless explicitly instructed by payer.
`QX`	Rendering provider NPI differs from billing provider	When the individual who performed or interpreted the test is different from the billing laboratory’s NPI.

Taxonomy Code	Specialty	Notes
207P00000X	Pathology	Transfusion medicine and blood bank pathologists who interpret molecular blood group testing.
208000000X	Hematology	Hematologists involved in transfusion decisions and alloimmunization management.
363L00000X	Clinical Laboratory	Clinical laboratory directors and technologists performing molecular assays.
207L00000X	Anatomic and Clinical Pathology	Laboratory physicians overseeing serologic and molecular blood typing workflows.
207R00000X	Transfusion Medicine	Specialists who coordinate donor selection and transfusion compatibility using genotyping data.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z51.0`	Encounter for antineoplastic chemotherapy and immunotherapy	Patients receiving chemotherapy often require transfusion support and may need genotyping to avoid alloimmunization complications.
`D75.8`	Other specified hematologic conditions	Broad category that can include hemolytic disorders or conditions necessitating detailed blood group workup.
`D56.9`	Sickle-cell disease, unspecified	Patients with chronic transfusion exposure frequently need extended antigen matching informed by genotyping.
`O36.80X0`	Maternal care for other specified fetal problems, not applicable or unspecified, first trimester	Used when fetal/newborn risk assessment for hemolytic disease of the fetus/newborn requires parental or fetal blood group genotyping.
`Z33.1`	Pregnant state, incidental	Pregnancy-related genotyping to assess risk of hemolytic disease of the newborn due to Kidd antigens.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86900`	Antiglobulin test (e.g., Coombs), direct and indirect	Serologic antibody detection often performed prior to molecular genotyping to identify red cell alloantibodies.
`86850`	Crossmatch, serological (major and minor)	Performed when preparing for transfusion; genotyping informs selection when serology is inconclusive.
`81265`	HLA typing; class I (A,B,C) sequencing-based typing	Performed in transplantation workflows alongside blood group genotyping for comprehensive compatibility assessment.
`88235`	Infectious agent detection by nucleic acid (e.g., PCR), qualitative or quantitative, each organism	Represents molecular laboratory workflows; listed when other molecular assays are ordered in the same episode of care.
`99000`	Handling and/or conveyance of specimen	Ancillary specimen handling operations that may be billed or documented in complex reference testing workflows.

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Summary & Overview

CPT 0192U: Navigator JK Sequencing for Kidd Blood Group Antigens

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0192UCPTProprietary Laboratory AnalysesGenetic SequencingImmunohematologyKidd Blood GroupTransfusion MedicinePerinatal Testing

Billing Code Overview

Service type: Genetic sequencing for immunohematology (proprietary laboratory test)
Typical site of service: Clinical laboratory or specialized reference laboratory using a blood specimen

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When only the physician’s interpretation or report is billed separately from the laboratory technical component.
`TC`	Technical component	When billing only the laboratory technical portion of the test (equipment, reagents, personnel) and a separate professional component is reported by a physician.
`90`	Reference (outside) laboratory	When the performing laboratory is different from the billing laboratory or when specimens are sent to an outside reference lab.
`62`	Two surgeons	Not typically used for laboratory tests; include only if two independent providers share professional responsibilities for interpretation.
`52`	Reduced services	When the test was partially performed or limited due to specimen quality or other constraints.
`53`	Discontinued service	If testing was started but discontinued for clinical or technical reasons prior to completion.
`59`	Distinct procedural service	When multiple unrelated services are billed on the same day and documentation supports distinct services (rare for a single PLA test).
`AD`	Advanced beneficiary notice waived	Use per payer rules when beneficiary has waived ABN requirements (payer-specific reporting).
`QW`	CLIA waived test	Not applicable to this complex molecular assay; do not use unless explicitly instructed by payer.
`QX`	Rendering provider NPI differs from billing provider	When the individual who performed or interpreted the test is different from the billing laboratory’s NPI.

Taxonomy Code	Specialty	Notes
207P00000X	Pathology	Transfusion medicine and blood bank pathologists who interpret molecular blood group testing.
208000000X	Hematology	Hematologists involved in transfusion decisions and alloimmunization management.
363L00000X	Clinical Laboratory	Clinical laboratory directors and technologists performing molecular assays.
207L00000X	Anatomic and Clinical Pathology	Laboratory physicians overseeing serologic and molecular blood typing workflows.
207R00000X	Transfusion Medicine	Specialists who coordinate donor selection and transfusion compatibility using genotyping data.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z51.0`	Encounter for antineoplastic chemotherapy and immunotherapy	Patients receiving chemotherapy often require transfusion support and may need genotyping to avoid alloimmunization complications.
`D75.8`	Other specified hematologic conditions	Broad category that can include hemolytic disorders or conditions necessitating detailed blood group workup.
`D56.9`	Sickle-cell disease, unspecified	Patients with chronic transfusion exposure frequently need extended antigen matching informed by genotyping.
`O36.80X0`	Maternal care for other specified fetal problems, not applicable or unspecified, first trimester	Used when fetal/newborn risk assessment for hemolytic disease of the fetus/newborn requires parental or fetal blood group genotyping.
`Z33.1`	Pregnant state, incidental	Pregnancy-related genotyping to assess risk of hemolytic disease of the newborn due to Kidd antigens.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86900`	Antiglobulin test (e.g., Coombs), direct and indirect	Serologic antibody detection often performed prior to molecular genotyping to identify red cell alloantibodies.
`86850`	Crossmatch, serological (major and minor)	Performed when preparing for transfusion; genotyping informs selection when serology is inconclusive.
`81265`	HLA typing; class I (A,B,C) sequencing-based typing	Performed in transplantation workflows alongside blood group genotyping for comprehensive compatibility assessment.
`88235`	Infectious agent detection by nucleic acid (e.g., PCR), qualitative or quantitative, each organism	Represents molecular laboratory workflows; listed when other molecular assays are ordered in the same episode of care.
`99000`	Handling and/or conveyance of specimen	Ancillary specimen handling operations that may be billed or documented in complex reference testing workflows.