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.
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.
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Service type: Genetic sequencing of blood group–related gene regions (proprietary laboratory test)
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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. |