Summary & Overview

CPT 0210U: BioPlex 2200 RPR Quantitative Syphilis Antibody Assay

CPT code 0210U denotes a Proprietary Laboratory Analyses (PLA) test: the BioPlex 2200 RPR Assay – Quantitative by Bio–Rad Laboratories, which quantifies syphilis-related antibody levels in blood. As a PLA code, 0210U uniquely identifies a single manufacturer’s assay rather than a class of tests, aiding clarity in billing and utilization tracking. Nationally, PLA codes like 0210U matter because they affect lab billing specificity, payer coverage decisions, and public health surveillance of infectious disease testing.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a consolidated view of coverage considerations and how 0210U appears across major commercial and federal payers. Readers will find benchmarks and context on clinical use, typical sites of service, and how PLA coding shapes reimbursement workflows. The analysis outlines clinical context—quantitative serologic assessment for syphilis—and operational implications for laboratories and billing teams, including typical specimen type and service setting.

The report does not provide state-specific guidance. Data not available in the input is noted where relevant. The content is intended to inform payers, laboratory administrators, policy analysts, and billing professionals about the role and implications of CPT code 0210U in national lab testing and payment landscapes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0210UCPTProprietary Laboratory AnalysesSyphilis testingSerologyLaboratory billingBioPlex 2200Reference laboratoryDiagnostic assay

Billing Code Overview

CPT code 0210U is a Proprietary Laboratory Analyses (PLA) code that describes a single, manufacturer-specific laboratory test: the BioPlex 2200 RPR Assay – Quantitative by Bio–Rad Laboratories. The test measures the level of syphilis-related antibodies in a patient specimen, typically using a blood sample.

Service type: Quantitative serologic testing for syphilis antibodies (proprietary laboratory assay)
Typical site of service: Clinical or reference laboratory processing blood specimens

Clinical & Coding Specifications

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:

Clinician encounter and documentation of exposure risk and symptoms.
Order placed for syphilis serology including quantitative non-treponemal testing (0210U).
Phlebotomy in clinic or specimen collected at facility; specimen labeled and shipped to laboratory.
Laboratory performs the BioPlex 2200 RPR Quantitative assay and generates the quantitative antibody level.
Laboratory report, including interpretive reference ranges and specimen processing (TC and 26 considerations), is transmitted to the ordering clinician.
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.

OpenPayer