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.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicare0202UCPTProprietary Laboratory AnalysesRespiratory PCR PanelBioFire FilmArrayLaboratoryInfectious DiseaseNasopharyngeal Test

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.

Service type: Automated PCR respiratory pathogen panel testing on nasopharyngeal specimens
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`

Taxonomy Code	Specialty	Notes
363A00000X	Clinical Pathology	Pathologists and laboratory medicine physicians overseeing molecular testing
207RC0000X	Emergency Medicine	Emergency physicians ordering testing in ED settings
261QP1100X	Infectious Disease	Consultants interpreting complex infectious disease results and management
208D00000X	General Practice	Primary care and urgent care clinicians ordering testing
207L00000X	Pulmonary Disease	Pulmonologists involved in management of patients with respiratory infections

ICD-10 Code	Description	Clinical Relevance
`J06.9`	Acute upper respiratory infection, unspecified	Common presentation prompting a respiratory pathogen panel to identify viral causes
`J12.89`	Other viral pneumonia	Severe lower respiratory infection where multiplex testing helps identify causative viral pathogens
`J22`	Unspecified acute lower respiratory infection	Used when a broad panel may identify viral or atypical bacterial pathogens
`J20.9`	Acute bronchitis, unspecified	Often investigated with respiratory panels in persistent or severe cases
`U07.1`	COVID-19	Direct indication for testing for SARS–CoV–2; panel includes SARS–CoV–2 detection
`R05`	Cough	Symptom code commonly paired with panel testing when respiratory infection is suspected
`R50.9`	Fever, unspecified	Non-specific systemic symptom that often triggers diagnostic testing including multiplex PCR

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87804`	Infectious agent antigen detection by immunoassay, multiple step method; respiratory syncytial virus	May be used as a rapid antigen test performed prior to or instead of multiplex PCR in some workflows
`87426`	Infectious agent detection by nucleic acid (DNA or RNA); influenza, multiplex amplified probe technique, multiple types/subtypes	Alternative molecular test for influenza that may be ordered separately or when a focused influenza assay is preferred
`87635`	Infectious agent detection by nucleic acid (DNA or RNA); SARS-CoV-2, amplified probe technique	SARS–CoV–2–specific molecular test that may be ordered if focused COVID-19 testing is required rather than a broad respiratory panel
`36415`	Collection of venous blood by venipuncture	Commonly performed in the same visit when clinicians obtain blood for other diagnostic testing or serologies
`99000`	Handling and/or conveyance of specimen for transfer between facilities	Used when specimen is transported to an external reference laboratory for testing

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