Summary & Overview
CPT 0202U: BioFire FilmArray Respiratory Panel 2.1 (Automated PCR)
CPT code 0202U designates a Proprietary Laboratory Analyses (PLA) test for the BioFire® FilmArray® Respiratory Panel 2.1 (RP2.1), an automated PCR assay on nasopharyngeal specimens that detects the most common viral and bacterial respiratory pathogens, including SARS–CoV–2. As a PLA code, 0202U applies to a single manufacturer-specific test, which affects coding clarity and payer adjudication across the country. Nationally, the code matters because respiratory multiplex PCR panels play a key role in diagnostic workflows, infection control, and public health surveillance, especially during respiratory virus seasons and pandemic response.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose and service setting for the test, payer coverage landscape, and typical billing context for a PLA code. The publication outlines reimbursement benchmarks, common modifier usage, and coding considerations relevant to laboratory and hospital billing teams. It also provides clinical context for when a multiplex respiratory PCR panel is used and summarizes policy points that influence payment and claims processing. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0202U is a Proprietary Laboratory Analyses (PLA) code for the BioFire® FilmArray® Respiratory Panel 2.1 (RP2.1) from BioFire® Diagnostics. The code covers an automated polymerase chain reaction (PCR) test performed on a nasopharyngeal specimen to detect common viral and bacterial respiratory pathogens, including SARS–CoV–2.
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Service type: Automated PCR respiratory pathogen panel testing on nasopharyngeal specimens
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Typical site of service: Clinical laboratories and laboratory sections within hospitals or outpatient diagnostic centers
Clinical & Coding Specifications
Clinical Context
A 46-year-old adult presents to an urgent care clinic in late fall with acute onset of fever, cough, nasal congestion, and mild shortness of breath for 48 hours. The clinician obtains a nasopharyngeal swab and orders the BioFire® FilmArray® Respiratory Panel 2.1 (RP2.1), reported under 0202U, to simultaneously detect common viral and bacterial respiratory pathogens including SARS–CoV–2. The specimen is processed in the facility’s molecular laboratory on the BioFire automated PCR system. Results are typically available the same day and used to guide isolation decisions, antiviral therapy, antibiotic stewardship, and disposition (return home, follow-up, or escalation to hospital care). Typical sites of service include hospital outpatient laboratories, urgent care centers, emergency departments, and independent clinical laboratories. The service type is automated molecular respiratory pathogen panel by nasopharyngeal specimen testing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When only the professional interpretation or reporting portion of the test is billed separately from the technical component |
TC |