Summary & Overview
CPT 0199U: Scianna Blood Group Sequencing, Navigator SC
CPT code 0199U designates a proprietary laboratory sequencing assay — the Navigator SC Sequencing test from Grifols Immunohematology Center — that identifies Scianna blood group antigens by analyzing specific gene sequences. This specialized genetic test supports clinical decision-making to minimize incompatible blood transfusions, reduce transplant mismatches, and manage perinatal and neonatal blood-group risks. As a PLA code, 0199U applies to a single manufacturer-specific test and has implications for coverage, billing, and laboratory reporting nationally.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an explanation of the clinical utility of the test, typical sites of service and specimen type, and how a PLA designation affects coding and billing processes. The publication outlines payer coverage considerations, common billing modifiers encountered in practice, and operational points relevant to hospital laboratories, transfusion services, and reference labs.
This summary provides clinicians, laboratory managers, and billing professionals with the clinical context and administrative details necessary to identify when CPT code 0199U is appropriate, understand the test's role in transfusion and transplant safety, and locate areas where payer policies and billing workflows commonly require attention. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0199U is a Proprietary Laboratory Analyses (PLA) code for the Navigator SC Sequencing test from Grifols Immunohematology Center. The test analyzes specific gene sequences to determine Scianna blood group antigens, information that can help clinicians reduce adverse blood–type incompatibility reactions in blood transfusions, organ transplants, and in pregnancy and newborn care.
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Service type: Genetic sequencing-based laboratory test to identify Scianna blood group antigen genotypes
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Typical site of service: Clinical laboratory or specialized immunohematology reference laboratory using a blood specimen
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or neonate requiring detailed blood group antigen characterization to guide transfusion, transplantation, or prenatal care. A clinician (transfusion medicine physician, obstetrician, or hematologist) orders the Navigator SC Sequencing test (0199U) when standard serologic typing is inconclusive, when patients have a history of alloimmunization, or when planning transfusion for patients with rare Scianna blood group variants. A blood specimen is collected (phlebotomy for adults, heel- or venipuncture for neonates) and sent to Grifols Immunohematology Center. The laboratory extracts DNA, performs targeted sequencing of the Scianna antigen–related gene regions, and reports genotype-predicted Scianna antigen status. Results are used by the blood bank to select compatible donor units, by transplant teams to reduce graft incompatibility risk, and by obstetric teams to assess fetal/newborn risk for hemolytic disease of the fetus and newborn.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the laboratory professional interpretation component distinct from technical processing (rare for PLA but used when applicable). |
TC |