Summary & Overview

CPT 0196U: Navigator LU Sequencing for Lutheran Blood Group

CPT code 0196U is a Proprietary Laboratory Analyses (PLA) code for the Navigator LU Sequencing test from Grifols Immunohematology Center, a laboratory genetic sequencing assay that identifies Lutheran (LU) blood group antigen genotypes from a blood specimen. The test is clinically relevant for preventing adverse blood‑type incompatibility events in transfusion medicine, organ transplantation, and perinatal/newborn care, making it a targeted diagnostic tool in precision transfusion and immunohematology workflows.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on what the code represents, the clinical context for its use, typical sites of service, and the service type. The publication also summarizes payer coverage patterns and benchmarking where available, outlines coding and billing considerations specific to PLA codes, and highlights clinical scenarios in which sequencing for Lutheran antigens may influence patient management. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0196UCPTProprietary Laboratory AnalysesLutheran blood groupgenetic sequencingtransfusion medicineimmunohematologyperinatal testinglaboratory

Billing Code Overview

CPT code 0196U is a Proprietary Laboratory Analyses (PLA) code for the Navigator LU Sequencing test from Grifols Immunohematology Center. The test sequences specific gene regions to determine Lutheran (LU) blood group antigen status, which can inform clinical decision-making to minimize adverse blood‑type incompatibility reactions in blood transfusions, organ transplantation, pregnancy, and newborn care.

Service type: Genetic sequencing of blood group–related gene regions (proprietary laboratory test)
Typical site of service: Clinical laboratory using a patient blood specimen (venous blood collection), with results reported to ordering clinicians for transfusion, transplant, perinatal, or neonatal management

Clinical & Coding Specifications

Clinical Context

A patient undergoing pre-transfusion compatibility testing or planning for organ transplant is referred for molecular blood group genotyping. Typical scenario: a pregnant woman with a history of prior transfusion, alloimmunization, or discrepant serologic Lutheran (LU) antigen typing, or a patient with multiple transfusions and complex serology, has a blood specimen (whole blood or EDTA) sent to a reference immunohematology laboratory. The laboratory performs the Navigator LU Sequencing test to analyze specific gene sequences that determine Lutheran blood group antigens. Results are used by the transfusion medicine team, obstetrics providers, or transplant teams to select compatible blood products, anticipate hemolytic disease of the fetus/newborn, or avoid alloimmune reactions during transplantation. The typical workflow: specimen collection and accessioning → test order and patient history review (including prior antibody records) → molecular sequencing using the proprietary assay → result interpretation and reporting with antigen genotype and clinical implications → documentation in the transfusion record and communication to ordering clinician and blood bank for product selection.

Coding Specifications

Modifier	Description	When to Use
`00`	Default code modifier (no specific CMS meaning)	Use per payer requirements when no other modifier applies and a placeholder modifier field is required by billing systems.

Taxonomy Code	Specialty	Notes
2085P0200X	Pathology & Laboratory Medicine	Clinical laboratory directors and transfusion medicine pathologists who oversee molecular blood group testing.
207RH0000X	Hematology	Hematologists managing transfusion-dependent patients and interpretation of complex serology.
207K00000X	Obstetrics & Gynecology	Obstetricians ordering testing for pregnant patients at risk for hemolytic disease of the fetus/newborn.
208D00000X	Transplant Surgery	Transplant surgeons/coordinators involved in donor–recipient compatibility planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D75.09`	Other hemolytic anemias	Molecular Lu genotyping helps identify alloimmune hemolysis risk related to Lutheran antigens.
`O36.0XX0`	Maternal care for known or suspected fetal abnormalities and damage, unspecified fetus	Used for pregnancies where fetal–maternal blood group incompatibility is being evaluated (placeholder for detailed fetal assessment).
`Z51.0`	Encounter for antineoplastic chemotherapy and immunotherapy	In patients receiving multiple transfusions during cancer treatment, extended antigen typing guides product selection.
`Z34.90`	Encounter for supervision of normal pregnancy, unspecified, unspecified trimester	Routine antenatal care when advanced blood group genotyping is ordered for prior alloimmunization history.
`Z48.21`	Encounter for aftercare following organ transplant	Post-transplant patients with prior alloantibodies may require extended genotyping for transfusion support.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86900`	Blood typing; ABO	Performed as initial serologic testing before or alongside molecular genotyping to establish ABO group.
`86901`	Blood typing; Rh(D)	Complementary serologic Rh(D) typing used with molecular LU results to determine full transfusion compatibility.
`86850`	Antibody screen, RBC antibodies (indirect antiglobulin test)	Identifies clinically significant alloantibodies that prompt molecular testing for blood group antigens such as Lutheran.
`86880`	Antibody identification; serum or plasma	Detailed serologic workup often precedes or accompanies molecular genotyping to resolve complex serology.
`81265`	HLA class I and II typing (sequence-based)	Performed in transplantation contexts alongside antigen genotyping for broader compatibility assessment.