Summary & Overview
CPT 0222U: Navigator Rh Blood Group NGS Test
CPT code 0222U identifies a proprietary next‑generation sequencing laboratory test — the Navigator Rh Blood Group NGS from Grifols Immunohematology Center — used to determine Rh blood group antigens from a blood specimen. Nationally, this PLA code matters because it standardizes reporting for a single‑manufacturer genomic assay that informs transfusion, transplant, and perinatal care to reduce antigen incompatibility risks.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for Rh antigen genotyping, typical sites of service, and common billing considerations. The publication summarizes available benchmarks where present, highlights policy and coding guidance relevant to PLA codes, and explains clinical implications for use of targeted genomic Rh typing in transfusion medicine and maternal–fetal care.
This summary is intended for a national audience of clinicians, laboratory directors, and reimbursement analysts seeking clear information on what CPT code 0222U represents, which payers are commonly engaged, and what topics (benchmarks, policy updates, and clinical context) are covered in the full publication.
Billing Code Overview
CPT code 0222U is a Proprietary Laboratory Analyses (PLA) code for the Navigator Rh Blood Group NGS test from Grifols Immunohematology Center. The test uses next‑generation sequencing of specific gene sequences to determine Rh blood group antigens. Results can help clinicians minimize adverse blood‑type incompatibility reactions in blood transfusion, organ transplant, pregnancy, and newborn care.
Service type: Genetic sequencing for Rh blood group antigen typing (laboratory diagnostic test)
Typical site of service: Clinical laboratory or hospital laboratory using a blood specimen
Clinical & Coding Specifications
Clinical Context
A typical patient is a pregnant person or a patient requiring blood transfusion or organ transplant evaluation whose prior serologic Rh typing is ambiguous or shows rare Rh variants. The clinician collects a peripheral blood specimen and sends it to the Grifols Immunohematology Center for the Navigator Rh Blood Group NGS test (0222U). The laboratory performs targeted next-generation sequencing of Rh blood group genes to determine specific Rh antigens and alleles. Results are used by transfusion medicine specialists, obstetricians, transplant teams, and newborn care providers to minimize hemolytic transfusion reactions, manage alloimmunization in pregnancy, guide antigen-matched blood selection, and assess donor–recipient compatibility. Typical workflow steps: physician orders test, phlebotomy obtains anticoagulated blood specimen, courier transports specimen to the performing laboratory, laboratory performs sequencing and bioinformatic analysis, laboratory issues a report of Rh antigen genotypes to ordering clinician, and transfusion or perinatal management decisions are informed by the report.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if separated from the technical component. |
TC | Technical component | Use when billing only the technical component (laboratory processing and sequencing) and the professional interpretation is billed separately. |
QK | CLIA waived laboratory test complexity indicator (performer) | Use per payer policy when identifying a test performed under specific CLIA categorizations if required by the payer (rare for PLA codes). |
QX | Modifier for services performed by a qualified nonphysician practitioner | Use when the test interpretation or supervisory component is performed by an authorized nonphysician practitioner when payer allows. |
QY | Diagnostic test facility setting | Use when indicating the test was performed in a diagnostic testing facility as required by some payers for PLA codes. |
22 | Increased procedural services | Use when documentation supports substantially greater effort or complexity in test analysis or reporting than usual. |
52 | Reduced services | Use if the laboratory performed a partial test battery or limited analysis relative to the full described service. |
80 | Assistant surgeon | Not commonly applicable to laboratory testing; included only if surgical assistant services are billed concurrently in the same episode (rare). |
78 | Unplanned return to the operating/procedure room | Not applicable to the test itself; include only when associated surgical procedures require reporting of return to OR. |
62 | Two surgeons | Not applicable to the laboratory test; include only when two surgeons are involved in a related operative episode. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | Not applicable to the lab test; include only if a related surgical episode involves these providers. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RH0000X | Pathology | Laboratory directors and clinical pathologists overseeing immunohematology and molecular testing. |
| 207L00000X | Clinical Laboratory | Medical laboratory scientists and directors responsible for technical testing, sequencing, and reporting. |
| 208D00000X | Diagnostic Radiology (placeholder for transfusion medicine specialists) | Transfusion medicine or hematology specialists who order and interpret Rh genotyping reports (use of related transfusion services). |
| 2080P0208X | Obstetrics & Gynecology | Obstetricians managing alloimmunized pregnancies and using results for perinatal planning. |
| 207K00000X | Hematology | Hematologists and transfusion medicine physicians coordinating blood compatibility and transfusion planning. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
O36.0 | Maternal care for known or suspected fetal problems related to Rh isoimmunization (placeholder category) | Used in pregnancy cases where Rh genotyping informs management of alloimmunization risk and fetal monitoring. |
D75.9 | Hematologic disorder, unspecified | May be used when transfusion planning requires detailed Rh antigen information in patients with complex hematologic needs. |
Z51.2 | Encounter for blood transfusion | Relevant when Rh genotyping is performed to guide safe blood product selection before or during transfusion therapy. |
Z34.90 | Encounter for supervision of normal pregnancy, unspecified, unspecified trimester | Used when Rh genotyping is part of prenatal evaluation for maternal–fetal blood group compatibility. |
Z76.89 | Other specified health care encounters | Used when Rh genotyping is performed for preoperative or donor compatibility evaluations not otherwise classified. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36415 | Collection of venous blood by venipuncture | Commonly performed immediately prior to 0222U to obtain the blood specimen for genotyping. |
86077 | Antibody identification; each procedure, including antisera and incubation, excluding red cell phenotyping | May be performed alongside molecular Rh genotyping for serologic correlation in alloimmunization workups. |
86900 | Blood typing, erythrocyte antigen typing; complete panel | Complementary serologic testing often done in parallel to molecular Rh genotyping to guide transfusion decisions. |
88291 | Interpretation and report of genetic test (if applicable) | May be used for professional interpretation/consultation coding when separate from the technical component, depending on payer rules. |
G0480 | Clinical laboratory test (Medicare example for molecular pathology, if applicable) | May be used in institutional billing contexts to represent molecular diagnostic services alongside PLA coding for coverage or payment mapping. |