Summary & Overview

CPT 0198U: Navigator RHD/CE Sequencing Test for Rh Antigen Genotyping

CPT code 0198U identifies a Proprietary Laboratory Analyses (PLA) test — the Navigator RHD/CE Sequencing assay from Grifols Immunohematology Center — used to characterize Rh blood group antigen genotypes. This sequencing-based test has clinical importance for reducing immune-mediated incompatibility in transfusion medicine, organ transplantation, and maternal-fetal care. Nationally, PLA codes like 0198U are tracked for unique-test reporting and can affect lab billing, claim adjudication, and utilization monitoring.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the test's clinical role, payer coverage considerations, and typical service and site of care. The publication outlines expected benchmarks for lab-based genetic assays, highlights policy-relevant elements tied to PLA coding, and summarizes the clinical context in which the test is used (transfusion compatibility, transplant planning, and perinatal/newborn evaluation).

This summary provides a national perspective for clinicians, laboratory administrators, and policy analysts on how CPT code 0198U is classified, where it is performed, and why it is clinically relevant in preventing Rh-related incompatibility events.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0198UCPTProprietary Laboratory AnalysesImmunohematologyRh typingGenetic sequencingTransfusion medicinePerinatal testing

Billing Code Overview

CPT code 0198U is a Proprietary Laboratory Analyses (PLA) code for the Navigator RHD/CE Sequencing test from Grifols Immunohematology Center. The test analyzes specific gene sequences to determine Rh blood group antigen status, which can inform clinical decisions to minimize adverse blood–type incompatibility reactions in blood transfusions, organ transplants, pregnancy, and care of newborns.

Service type: Genetic sequencing-based immunohematology assay performed by a specialized laboratory.
Typical site of service: Clinical laboratory or specialized reference laboratory using a blood specimen.

Clinical & Coding Specifications

Clinical Context

A 28-year-old pregnant woman presents for routine prenatal care after a prior pregnancy complicated by hemolytic disease of the newborn. Her obstetrician orders molecular Rh blood group genotyping to clarify maternal and fetal Rh antigen status when serologic typing is inconclusive or when variant Rh alleles are suspected. A blood specimen is collected in the clinic and sent to Grifols Immunohematology Center for the Navigator RHD/CE Sequencing test billed with 0198U. The laboratory performs targeted sequencing of RHD and RHCE gene regions, interprets variants that affect RhD and RhCE antigen expression, and reports results to the ordering clinician. Results inform transfusion planning, antenatal antibody management, and neonatal risk assessment. Typical site of service is an outpatient clinic or hospital outpatient laboratory; the service type is a proprietary laboratory molecular diagnostic test (Proprietary Laboratory Analyses, PLA).

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the professional (interpretive) component of the test if separated from technical component.
`TC`	Technical component	Use when billing only the technical (laboratory processing) component of the test.
`90`	Reference (outside) laboratory	Use when the performing laboratory is different from the billing laboratory that forwarded the specimen to Grifols.
`91`	Repeat clinical diagnostic laboratory test performed for monitoring (Note: not in provided list)	Data not available in the input.
`91`	Data not available in the input.	Data not available in the input.
`91`	Data not available in the input.	Data not available in the input.

Taxonomy Code	Specialty	Notes
2083P0800X	Hematology	Specialists ordering complex blood group genotyping and interpreting results for transfusion or perinatal care.
207RC0000X	Obstetrics & Gynecology	Obstetricians managing alloimmunization in pregnancy and assessing fetal risk.
208D00000X	Pathology	Transfusion medicine pathologists overseeing molecular immunohematology testing and reporting.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`O36.0130`	Maternal care for known or suspected isoimmunization, first trimester, unspecified fetus and placenta	Used when assessing maternal alloimmunization risk and Rh antigen status in pregnancy.
`D75.81`	Nonautoimmune hemolytic anemia	Relevant when hemolysis may be due to blood group incompatibility; Rh genotyping can clarify cause.
`Z34.90`	Encounter for supervision of normal pregnancy, unspecified trimester	Routine prenatal scenarios where molecular Rh typing may be ordered if prior history or serologic ambiguity exists.
`Z51.89`	Encounter for other specified aftercare and medical care	May be used for follow-up encounters related to transfusion planning or postnatal management informed by genotyping.
`T86.20`	Unspecified complication of transplant of bone marrow (example related to transfusion compatibility)	Rh antigen genotyping can be relevant in transplant planning when blood-type incompatibility is a concern.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Often performed immediately prior to molecular Rh genotyping to obtain the specimen for `0198U`.
`86706`	Antibody; Rh (D) (Not appropriate for variant molecular typing)	Serologic Rh(D) typing commonly performed before or alongside molecular testing; molecular testing used when serology is inconclusive.
`88112`	Cytopathology, slides prepared and interpreted (example related lab interpretation code)	Laboratory interpretation and review workflows may include slide-based or supplemental analyses in complex cases; used less commonly with sequencing.
`88360`	Immunohistochemistry (per specimen) (example ancillary lab code)	Ancillary testing codes may appear in workflows assessing antigen expression but are not direct substitutes for molecular PLA testing.
`81479`	Unlisted molecular pathology procedure	Historically used when a specific PLA code was not available; `0198U` replaces use of unlisted code for this proprietary test.