CPT 0225U: ePlex Respiratory Pathogen Panel 2, Multiplex RT–PCR

CPT code 0225U reports the ePlex® Respiratory Pathogen Panel 2 (GenMark Dx) — a Proprietary Laboratory Analyses (PLA) multiplex RT–PCR assay with electrochemical detection for common viral and bacterial respiratory pathogens, including SARS–CoV–2; service type: molecular diagnostic laboratory test (multiplex respiratory pathogen panel); typical site of service: clinical laboratory or hospital laboratory performing high-complexity molecular testing.

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CPT 0225U: ePlex Respiratory Pathogen Panel 2, Multiplex RT–PCR

Customize your policy alerts

Sign up for cpt 0225U policy alerts

Get alerted when payer policies referencing 0225U are released or updated.

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Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A patient presents to an urgent care clinic in late fall with acute onset of fever, cough, nasal congestion, sore throat, and myalgias. The clinician evaluates the patient and documents upper respiratory signs with possible lower respiratory involvement and potential exposure to SARS–CoV–2. A respiratory specimen (nasopharyngeal swab or nasal swab) is collected and sent to the on-site or reference laboratory for multiplex molecular testing.

The laboratory performs the ePlex® Respiratory Pathogen Panel 2, GenMark Dx, reported with CPT code 0225U. This is a proprietary multiplex RT–PCR assay with electrochemical detection that identifies common viral and selected bacterial respiratory pathogens, including SARS–CoV–2. Results are typically reported within a single test run and returned to the ordering clinician to guide infection control, antiviral therapy decisions, antibiotic stewardship, and disposition (home versus inpatient). Typical sites of service include hospital laboratories, outpatient clinics with on-site lab services, urgent care centers, and reference laboratories.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87471`	Infectious agent detection by nucleic acid (DNA or RNA); Influenza A, direct probe technique	Often ordered alongside multiplex panels when focused influenza testing is required or for confirmation.
`87635`	Infectious agent detection by nucleic acid (DNA or RNA); SARS–CoV–2 (COVID-19), amplified probe technique	Commonly ordered or used in parallel when dedicated SARS–CoV–2 testing is needed outside the multiplex panel.
`87804`	Infectious agent antigen detection by immunoassay, multiple respiratory viruses	May be performed as a rapid point-of-care test in triage before or after multiplex molecular testing.
`87420`	Infectious agent detection by nucleic acid (DNA or RNA); Adenovirus, amplified probe technique	Specific pathogen testing that may be ordered if the multiplex panel is not available or to confirm specific targets.
`99000`	Handling and/or conveyance of specimen (specimen handling)	Ancillary service code used by some facilities for specimen pick-up/transport associated with laboratory testing.

Related Modifiers

5 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
251B00000X	Case Management Agency	An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
225XM0800X	Mental Health Occupational Therapist	Occupational therapists provide treatment for people recovering from a mental or physical illness to regain their independence and stability and to en…
2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, e…
2278P1005X	Pulmonary Rehabilitation Certified Respiratory Therapist	The respiratory therapist can assist the chronic pulmonary patient in returning to an optimal role in society by providing an effective program. It i…

Related ICD-10-CM Codes

26 rows

ICD-10-CM Code	Description
A49.9	Bacterial infection, unspecified
B34.9	Viral infection, unspecified
B97.21	SARS-associated coronavirus as the cause of diseases classified elsewhere
J00	Acute nasopharyngitis [common cold]
J02.9	Acute pharyngitis, unspecified
J03.90	Acute tonsillitis, unspecified
J04.0	Acute laryngitis
J06.9	Acute upper respiratory infection, unspecified
J10.1	Influenza due to other identified influenza virus with other respiratory manifestations
J11.1	Influenza due to unidentified influenza virus with other respiratory manifestations

Showing 1–10 of 26

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression test

CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

CPT 0007U: ToxProtect Urine Drug Screen With DNA Authentication

CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

CPT 0008U: H. pylori Antibiotic Resistance Gene Panel

CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

CPT 0011U: Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcripts

Showing 1–10 of 536

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87471`	Infectious agent detection by nucleic acid (DNA or RNA); Influenza A, direct probe technique	Often ordered alongside multiplex panels when focused influenza testing is required or for confirmation.
`87635`	Infectious agent detection by nucleic acid (DNA or RNA); SARS–CoV–2 (COVID-19), amplified probe technique	Commonly ordered or used in parallel when dedicated SARS–CoV–2 testing is needed outside the multiplex panel.
`87804`	Infectious agent antigen detection by immunoassay, multiple respiratory viruses	May be performed as a rapid point-of-care test in triage before or after multiplex molecular testing.
`87420`	Infectious agent detection by nucleic acid (DNA or RNA); Adenovirus, amplified probe technique	Specific pathogen testing that may be ordered if the multiplex panel is not available or to confirm specific targets.
`99000`	Handling and/or conveyance of specimen (specimen handling)	Ancillary service code used by some facilities for specimen pick-up/transport associated with laboratory testing.

Related Modifiers

5 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
251B00000X	Case Management Agency	An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
225XM0800X	Mental Health Occupational Therapist	Occupational therapists provide treatment for people recovering from a mental or physical illness to regain their independence and stability and to en…
2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, e…
2278P1005X	Pulmonary Rehabilitation Certified Respiratory Therapist	The respiratory therapist can assist the chronic pulmonary patient in returning to an optimal role in society by providing an effective program. It i…

Related ICD-10-CM Codes

26 rows

ICD-10-CM Code	Description
A49.9	Bacterial infection, unspecified
B34.9	Viral infection, unspecified
B97.21	SARS-associated coronavirus as the cause of diseases classified elsewhere
J00	Acute nasopharyngitis [common cold]
J02.9	Acute pharyngitis, unspecified
J03.90	Acute tonsillitis, unspecified
J04.0	Acute laryngitis
J06.9	Acute upper respiratory infection, unspecified
J10.1	Influenza due to other identified influenza virus with other respiratory manifestations
J11.1	Influenza due to unidentified influenza virus with other respiratory manifestations

Showing 1–10 of 26

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression test

CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

CPT 0007U: ToxProtect Urine Drug Screen With DNA Authentication

CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

CPT 0008U: H. pylori Antibiotic Resistance Gene Panel

CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

CPT 0011U: Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcripts

Showing 1–10 of 536

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 0225U: ePlex Respiratory Pathogen Panel 2, Multiplex RT–PCR

Sign up for cpt 0225U policy alerts

OpenPayer

CPT 0225U: ePlex Respiratory Pathogen Panel 2, Multiplex RT–PCR

Sign up for cpt 0225U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

CPT 0225U: ePlex Respiratory Pathogen Panel 2, Multiplex RT–PCR

Sign up for cpt 0225U policy alerts

CPT 0225U: ePlex Respiratory Pathogen Panel 2, Multiplex RT–PCR

Sign up for cpt 0225U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does CPT 0225U represent?

Where is the ePlex Respiratory Pathogen Panel 2 typically performed?

Which billing modifiers are applicable to 0225U and when are they used?

What related CPT codes might be billed with or instead of 0225U?

Which diagnosis codes are commonly associated with orders for 0225U?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does CPT 0225U represent?

Where is the ePlex Respiratory Pathogen Panel 2 typically performed?

Which billing modifiers are applicable to 0225U and when are they used?

What related CPT codes might be billed with or instead of 0225U?

Which diagnosis codes are commonly associated with orders for 0225U?

References