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.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0199UCPTProprietary Laboratory AnalysesGenetic SequencingImmunohematologyBlood Group TestingTransfusion Safety

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.

Service type: Genetic sequencing-based laboratory test to identify Scianna blood group antigen genotypes
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`	Technical component	When billing only the laboratory technical component (sequencing, reagents, instrumentation).
`59`	Data not available in the input.	Data not available in the input.
`52`	Reduced services	If testing is partially performed or limited by specimen quality or partial gene coverage.
`53`	Discontinued procedure	When testing is started but stopped due to specimen failure or other uncontrollable events.
`62`	Two surgeons or providers	When two qualified providers from different specialties are required for specimen collection or interpretation (rare).
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for related care	When an intraoperative sample prompts repeat testing related to the same surgical episode (rare).
`80`	Assistant surgeon	When an assistant surgeon is separately reported for a procedure associated with specimen acquisition (rare).
`82`	Assistant surgeon (when qualified resident surgeon not available)	Similar limited use as `80` when no resident is available.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	When an advanced practice clinician assists in specimen acquisition intraoperatively.
`QK`	Performance and payment when performed by an independent laboratory vendor	When a separate independent laboratory performs the sequencing and bills separately.
`QX`	Modifier for CLIA-waived laboratory personnel performing the test	When qualified nonphysician lab personnel perform components within CLIA scope.
`QY`	Laboratory test certified under the Clinical Laboratory Improvement Amendments (CLIA) of 1988	To indicate CLIA-certified laboratory performance of the test.

Taxonomy Code	Specialty	Notes
207RH0000X	Transfusion Medicine	Blood bank and immunohematology specialists who order and interpret Scianna genotype testing.
207L00000X	Pathology	Molecular pathology and clinical laboratory medicine providers overseeing testing.
207K00000X	Hematology	Hematologists managing alloimmunized patients and transfusion strategies.
208D00000X	Obstetrics & Gynecology	Obstetricians ordering testing for pregnancies at risk for hemolytic disease of the fetus/newborn.
208000000X	Pediatrics	Pediatricians and neonatologists caring for newborns with suspected hemolytic disease or transfusion needs.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D75.82`	Alloimmune hemolytic anemia	Relevant when prior alloimmunization prompts extended genotyping to identify Scianna antigens to prevent transfusion reactions.
`O36.5XX0`	Maternal care for known or suspected fetal blood group incompatibility, unspecified trimester	Used when pregnancy management requires fetal/newborn Scianna antigen status assessment.
`Z53.2`	Blood transfusion	Indicates transfusion history or planning where Scianna genotyping guides compatible unit selection.
`Z86.73`	Personal history of other diseases of the blood and blood-forming organs	Past hematologic immune conditions that may motivate extended blood group genotyping.
`P55.9`	Neonatal hemolytic disease, unspecified	Newborns with hemolysis where parental and neonatal Scianna genotyping can inform diagnosis and management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Typical specimen collection method prior to sending sample for `0199U`.
`88342`	Immunohistochemistry or special stains (not directly genotyping)	May be used in parallel when tissue-based antigen testing is required; not a substitute for sequencing.
`81162`	CYP2C19 gene analysis (example of molecular targeted sequencing PLA alternative)	Represents other targeted molecular assays; reflects laboratory workflow similarity (nucleic acid extraction, sequencing, interpretation).
`81265`	RHD (Rh) gene analysis	Common parallel transfusion medicine molecular test for blood group genotyping; often ordered alongside Scianna genotyping to fully characterize blood group profile.
`P9610`	Blood product procurement (example code for transfusion-related services)	Clinical workflow often includes ordering compatible blood products after `0199U` results inform donor selection.

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Summary & Overview

CPT 0199U: Scianna Blood Group Sequencing, Navigator SC

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0199UCPTProprietary Laboratory AnalysesGenetic SequencingImmunohematologyBlood Group TestingTransfusion Safety

Billing Code Overview

Service type: Genetic sequencing-based laboratory test to identify Scianna blood group antigen genotypes
Typical site of service: Clinical laboratory or specialized immunohematology reference laboratory using a blood specimen

Clinical & Coding Specifications

Clinical Context

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`	Technical component	When billing only the laboratory technical component (sequencing, reagents, instrumentation).
`59`	Data not available in the input.	Data not available in the input.
`52`	Reduced services	If testing is partially performed or limited by specimen quality or partial gene coverage.
`53`	Discontinued procedure	When testing is started but stopped due to specimen failure or other uncontrollable events.
`62`	Two surgeons or providers	When two qualified providers from different specialties are required for specimen collection or interpretation (rare).
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for related care	When an intraoperative sample prompts repeat testing related to the same surgical episode (rare).
`80`	Assistant surgeon	When an assistant surgeon is separately reported for a procedure associated with specimen acquisition (rare).
`82`	Assistant surgeon (when qualified resident surgeon not available)	Similar limited use as `80` when no resident is available.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	When an advanced practice clinician assists in specimen acquisition intraoperatively.
`QK`	Performance and payment when performed by an independent laboratory vendor	When a separate independent laboratory performs the sequencing and bills separately.
`QX`	Modifier for CLIA-waived laboratory personnel performing the test	When qualified nonphysician lab personnel perform components within CLIA scope.
`QY`	Laboratory test certified under the Clinical Laboratory Improvement Amendments (CLIA) of 1988	To indicate CLIA-certified laboratory performance of the test.

Taxonomy Code	Specialty	Notes
207RH0000X	Transfusion Medicine	Blood bank and immunohematology specialists who order and interpret Scianna genotype testing.
207L00000X	Pathology	Molecular pathology and clinical laboratory medicine providers overseeing testing.
207K00000X	Hematology	Hematologists managing alloimmunized patients and transfusion strategies.
208D00000X	Obstetrics & Gynecology	Obstetricians ordering testing for pregnancies at risk for hemolytic disease of the fetus/newborn.
208000000X	Pediatrics	Pediatricians and neonatologists caring for newborns with suspected hemolytic disease or transfusion needs.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D75.82`	Alloimmune hemolytic anemia	Relevant when prior alloimmunization prompts extended genotyping to identify Scianna antigens to prevent transfusion reactions.
`O36.5XX0`	Maternal care for known or suspected fetal blood group incompatibility, unspecified trimester	Used when pregnancy management requires fetal/newborn Scianna antigen status assessment.
`Z53.2`	Blood transfusion	Indicates transfusion history or planning where Scianna genotyping guides compatible unit selection.
`Z86.73`	Personal history of other diseases of the blood and blood-forming organs	Past hematologic immune conditions that may motivate extended blood group genotyping.
`P55.9`	Neonatal hemolytic disease, unspecified	Newborns with hemolysis where parental and neonatal Scianna genotyping can inform diagnosis and management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Typical specimen collection method prior to sending sample for `0199U`.
`88342`	Immunohistochemistry or special stains (not directly genotyping)	May be used in parallel when tissue-based antigen testing is required; not a substitute for sequencing.
`81162`	CYP2C19 gene analysis (example of molecular targeted sequencing PLA alternative)	Represents other targeted molecular assays; reflects laboratory workflow similarity (nucleic acid extraction, sequencing, interpretation).
`81265`	RHD (Rh) gene analysis	Common parallel transfusion medicine molecular test for blood group genotyping; often ordered alongside Scianna genotyping to fully characterize blood group profile.
`P9610`	Blood product procurement (example code for transfusion-related services)	Clinical workflow often includes ordering compatible blood products after `0199U` results inform donor selection.