Clinical Context
A 28-year-old sexually active patient presents to an outpatient clinic with concerns about possible syphilis exposure after a partner tested positive. The clinician documents history of recent unprotected sexual contact and orders serologic testing. A blood specimen is collected via venipuncture and sent to the laboratory for treponemal and non-treponemal testing. The laboratory performs the BioPlex 2200 RPR Assay – Quantitative (0210U) to evaluate the level of non-treponemal syphilis-related antibodies. Results are returned to the ordering clinician and used alongside treponemal test results, clinical exam, and sexual history to determine diagnosis, staging, and need for treatment or follow-up testing.
Common workflow steps:
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Clinician encounter and documentation of exposure risk and symptoms.
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Order placed for syphilis serology including quantitative non-treponemal testing (0210U).
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Phlebotomy in clinic or specimen collected at facility; specimen labeled and shipped to laboratory.
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Laboratory performs the BioPlex 2200 RPR Quantitative assay and generates the quantitative antibody level.
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Laboratory report, including interpretive reference ranges and specimen processing (TC and 26 considerations), is transmitted to the ordering clinician.
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Clinician reviews combined serology results, documents interpretation, and communicates diagnosis and follow-up plan to the patient.
Coding Specifications
| Modifier | Description | When to Use |
|---|
00 | Reserved for future use | Data not available in the input. |
11 | Office or other outpatient visit | Data not available in the input.
22 | Increased procedural services | Use when the laboratory documents additional work or complexity beyond standard assay processing that materially increases resources.
26 | Professional component | Use if billing separately for the professional interpretation component by a physician or qualified provider.
52 | Reduced services | Use when the assay or reporting is partially performed or limited versus the full test.
53 | Discontinued procedure | Use if testing was started but discontinued for documented clinical reasons.
54 | Surgical care only | Data not available in the input.
55 | Postoperative management only | Data not available in the input.
62 | Two surgeons | Data not available in the input.
78 | Unplanned return to the operating room | Data not available in the input.
80 | Assistant surgeon | Data not available in the input.
QK | Qualified non-physician laboratory personnel | Use when the professional component or supervision involves qualified non-physician lab personnel under applicable payer rules.
QX | Service furnished by a CRNA with a physician not present | Data not available in the input.
QY | Medical supervision by a physician | Use when the physician provides the required level of medical supervision for the laboratory testing process.
TC | Technical component | Use when billing only for the laboratory technical component (instrumentation, reagents, technician time) of 0210U.
| Taxonomy Code | Specialty | Notes |
|---|
207Q00000X | Infectious Disease | Clinicians who diagnose and manage syphilis and interpret serology. |
207K00000X | Family Medicine | Primary care providers who order screening and diagnostic syphilis tests.
207L00000X | Internal Medicine | Hospital- and clinic-based physicians who order and act on serologic results.
363LA2200X | Laboratory - Pathology | Clinical laboratory directors and pathologists overseeing serologic testing and result interpretation.
363LF0006X | Laboratory - Clinical Chemistry | Laboratory professionals performing automated immunoassays like BioPlex systems.
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|
A53.9 | Syphilis, unspecified | Common diagnosis associated with ordering quantitative RPR testing to evaluate active infection. |
A53.0 | Early syphilis, primary | Non-treponemal quantitative testing is used for initial evaluation and treatment monitoring.
A53.1 | Early syphilis, secondary | Quantitative RPR assists in diagnosis and treatment response assessment.
A53.2 | Early syphilis, latent | Serologic testing differentiates latent infection stage and guides management.
Z11.3 | Encounter for screening for infections with a predominantly sexual mode of transmission | Screening encounters frequently include non-treponemal quantitative testing such as 0210U.
O98.11 | Syphilis complicating pregnancy, unspecified | Pregnant patients require quantitative testing for diagnosis and monitoring of treatment response.
R68.89 | Other general symptoms and signs | When nonspecific symptoms prompt an infectious workup including syphilis serology.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|
80053 | Comprehensive metabolic panel | Common concomitant laboratory tests ordered during an infectious disease workup or screening visit. |
86592 | Syphilis serologic test, quantitative non-treponemal (e.g., RPR) | Historically used for quantitative non-treponemal testing; 0210U is a PLA describing a specific manufacturer's automated quantitative RPR assay and may be performed in place of or alongside broader non-PLA codes.
86631 | Treponema pallidum antibody (confirmatory treponemal test) | Performed alongside non-treponemal quantitative tests to confirm syphilis infection.
36415 | Collection of venous blood by venipuncture | Performed before laboratory assays to obtain the specimen for 0210U.
99000 | Handling and/or conveyance of specimen to a laboratory | Used in some facility billing contexts for specimen transport logistics related to laboratory testing.