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CPT 0243U: PlGF Preeclampsia Screen, Proprietary Risk Score

CPT code 0243U identifies a proprietary laboratory test: the PlGF Preeclampsia Screen developed and marketed by PerkinElmer Genetics, Inc. The assay measures placental growth factor (PlGF) in maternal serum via time–resolved fluorescence immunoassay and uses a manufacturer-specific algorithm to report a pregnancy risk score for developing preeclampsia. The code is nationally relevant because preeclampsia risk assessment informs prenatal monitoring and management and proprietary PLA codes are linked to single-source tests with specific clinical and billing considerations. Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise synthesis of clinical purpose, payer coverage patterns, and typical sites of service for CPT code 0243U. The publication outlines benchmarks and policy context relevant to proprietary laboratory analyses, describes where the test is performed and how results are reported, and summarizes common billing considerations associated with single-source PLA codes. Data not available in the input will be noted where applicable.

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Billing Code Overview

CPT code 0243U is a Proprietary Laboratory Analyses (PLA) code assigned to the PlGF Preeclampsia Screen by PerkinElmer Genetics, Inc. The test measures placental growth factor (PlGF) in a maternal serum specimen using a time–resolved fluorescence immunoassay and applies a proprietary algorithm to generate a risk score for a patient developing preeclampsia.

Service type: Laboratory diagnostic test that quantifies PlGF and produces a proprietary risk score for preeclampsia
Typical site of service: Clinical laboratory or specialty diagnostic laboratory; specimen collection typically occurs in outpatient obstetric clinics or hospital prenatal care settings

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CPT 0243U: PlGF Preeclampsia Screen, Proprietary Risk Score

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Billing Code Overview

Service type: Laboratory diagnostic test that quantifies PlGF and produces a proprietary risk score for preeclampsia
Typical site of service: Clinical laboratory or specialty diagnostic laboratory; specimen collection typically occurs in outpatient obstetric clinics or hospital prenatal care settings

Clinical & Coding Specifications

Clinical Context

A pregnant patient in the second or third trimester presents for risk assessment due to new‑onset hypertension, abnormal fetal growth, or symptoms concerning for preeclampsia (for example, persistent headache, visual changes, or epigastric pain). Her obstetric provider orders the PlGF Preeclampsia Screen (0243U) performed by PerkinElmer Genetics, Inc. A maternal serum specimen is collected in an outpatient ambulatory clinic, hospital outpatient laboratory, or inpatient labor and delivery unit and sent to the performing laboratory. The assay uses time–resolved fluorescence immunoassay and a proprietary algorithm to generate a risk score for developing preeclampsia. Results are reported to the ordering clinician and integrated into prenatal care decisions, such as increased surveillance, hospitalization, laboratory monitoring (platelets, liver enzymes, creatinine), antihypertensive therapy considerations, or timing of delivery. Documentation includes indication, gestational age at draw, specimen collection details, method or performing lab name, and the numeric or categorical risk result.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (unmodified)	Use when no specific modifier applies and full global service billed
`26`	Professional component	Use when billing only the professional interpretation component separate from technical component
`TC`	Technical component	Use when billing only the technical component (laboratory performance)
`52`	Reduced services	Use when the test was partially reduced or specimen inadequate but performed in part
`53`	Discontinued procedure	Use if the specimen collection was abandoned for clinical reasons before completion
`59`	Data not available in the input.	Data not available in the input.
`QK`	Clinical laboratory improvement amendments (CLIA) waived test — specific to contractor reporting	Use when payer requires contractor-specific CLIA-related identifier (rare for PLA)
`QX`	Ordering/Referring NPI not on file (modifier used with lab reporting)	Use when compliance requires specifying a distinct billing arrangement for services ordered by another entity
`QY`	Ordering/Referring NPI on file (laboratory billing)	Use to indicate the lab test was ordered by the billing provider as required by some payers
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	Use if the specimen was collected or the service was ordered by these advanced practitioners and payer requires identification

Taxonomy Code	Specialty	Notes
207Q00000X	Obstetrics & Gynecology	Primary ordering specialty for prenatal testing and preeclampsia risk assessment
207V00000X	Maternal-Fetal Medicine	Specialists managing high‑risk pregnancies who commonly order PlGF testing
363L00000X	Clinical Laboratory	Performing laboratory or pathology specialty responsible for test execution and reporting
207K00000X	Family Medicine	Primary care providers managing prenatal patients in some settings
208000000X	Internal Medicine	Hospitalist or inpatient providers who may order testing during admissions

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`O13.9`	Gestational (pregnancy-induced) hypertension without significant proteinuria	Maternal hypertension prompting risk assessment for progression to preeclampsia where PlGF testing can inform risk
`O14.0`	Mild to moderate preeclampsia	Directly related diagnosis where PlGF levels help stratify severity and management decisions
`O14.1`	Severe preeclampsia	Low PlGF may correlate with severe disease; test assists monitoring and timing of delivery
`O14.2`	HELLP syndrome	Preeclampsia variant; PlGF results contribute to overall assessment though laboratory diagnosis relies on specific labs (platelets, AST, LDH)
`O36.84`	Maternal care for suspected preeclampsia	Assigned when preeclampsia is suspected and diagnostic risk assessment with PlGF is performed

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Specimen collection method commonly performed immediately prior to sending serum for the PlGF assay
`81002`	Urinalysis, by dipstick or tablet reagent for non‑automated, without microscopy	Often performed alongside when evaluating hypertensive pregnant patients for proteinuria
`80061`	Lipid panel (cholesterol, triglycerides, HDL, LDL)	Occasionally ordered in comprehensive maternal evaluation but not directly required for PlGF testing
`82728`	Vitamin D; 25‑hydroxyvitamin D	Example of ancillary laboratory testing sometimes ordered in prenatal workups
`87086`	Culture, bacterial, quantitative colony count, urine	May be performed concurrently if urinary tract infection is suspected in a hypertensive pregnant patient
`99000`	Handling and/or conveyance of specimen to a laboratory	Use when billing requires reporting of specimen transport services associated with sending the maternal serum to the performing laboratory

CPT 0001U: PreciseType HEA Multiplex Erythrocyte Antigen Assay

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

CPT 0002U: Urine Metabolomic Polyp Risk Assay (PolypDX™)

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

CPT 0003U: Overa™ (OVA1 Next Generation) Ovarian Cancer Risk Assay

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

CPT 0005U: ExosomeDx Prostate (IntelliScore) Urine Gene Expression Risk 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 Panel, Gene Sequence Analysis

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: Cordant CORE™ 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 Transcript Testing

Showing 1–10 of 536

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.

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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

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (unmodified)	Use when no specific modifier applies and full global service billed
`26`	Professional component	Use when billing only the professional interpretation component separate from technical component
`TC`	Technical component	Use when billing only the technical component (laboratory performance)
`52`	Reduced services	Use when the test was partially reduced or specimen inadequate but performed in part
`53`	Discontinued procedure	Use if the specimen collection was abandoned for clinical reasons before completion
`59`	Data not available in the input.	Data not available in the input.
`QK`	Clinical laboratory improvement amendments (CLIA) waived test — specific to contractor reporting	Use when payer requires contractor-specific CLIA-related identifier (rare for PLA)
`QX`	Ordering/Referring NPI not on file (modifier used with lab reporting)	Use when compliance requires specifying a distinct billing arrangement for services ordered by another entity
`QY`	Ordering/Referring NPI on file (laboratory billing)	Use to indicate the lab test was ordered by the billing provider as required by some payers
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	Use if the specimen was collected or the service was ordered by these advanced practitioners and payer requires identification

Taxonomy Code	Specialty	Notes
207Q00000X	Obstetrics & Gynecology	Primary ordering specialty for prenatal testing and preeclampsia risk assessment
207V00000X	Maternal-Fetal Medicine	Specialists managing high‑risk pregnancies who commonly order PlGF testing
363L00000X	Clinical Laboratory	Performing laboratory or pathology specialty responsible for test execution and reporting
207K00000X	Family Medicine	Primary care providers managing prenatal patients in some settings
208000000X	Internal Medicine	Hospitalist or inpatient providers who may order testing during admissions

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`O13.9`	Gestational (pregnancy-induced) hypertension without significant proteinuria	Maternal hypertension prompting risk assessment for progression to preeclampsia where PlGF testing can inform risk
`O14.0`	Mild to moderate preeclampsia	Directly related diagnosis where PlGF levels help stratify severity and management decisions
`O14.1`	Severe preeclampsia	Low PlGF may correlate with severe disease; test assists monitoring and timing of delivery
`O14.2`	HELLP syndrome	Preeclampsia variant; PlGF results contribute to overall assessment though laboratory diagnosis relies on specific labs (platelets, AST, LDH)
`O36.84`	Maternal care for suspected preeclampsia	Assigned when preeclampsia is suspected and diagnostic risk assessment with PlGF is performed

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Specimen collection method commonly performed immediately prior to sending serum for the PlGF assay
`81002`	Urinalysis, by dipstick or tablet reagent for non‑automated, without microscopy	Often performed alongside when evaluating hypertensive pregnant patients for proteinuria
`80061`	Lipid panel (cholesterol, triglycerides, HDL, LDL)	Occasionally ordered in comprehensive maternal evaluation but not directly required for PlGF testing
`82728`	Vitamin D; 25‑hydroxyvitamin D	Example of ancillary laboratory testing sometimes ordered in prenatal workups
`87086`	Culture, bacterial, quantitative colony count, urine	May be performed concurrently if urinary tract infection is suspected in a hypertensive pregnant patient
`99000`	Handling and/or conveyance of specimen to a laboratory	Use when billing requires reporting of specimen transport services associated with sending the maternal serum to the performing laboratory

CPT 0001U: PreciseType HEA Multiplex Erythrocyte Antigen Assay

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

CPT 0002U: Urine Metabolomic Polyp Risk Assay (PolypDX™)

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

CPT 0003U: Overa™ (OVA1 Next Generation) Ovarian Cancer Risk Assay

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

CPT 0005U: ExosomeDx Prostate (IntelliScore) Urine Gene Expression Risk 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 Panel, Gene Sequence Analysis

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: Cordant CORE™ 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 Transcript Testing

Showing 1–10 of 536

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.

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CPT 0243U: PlGF Preeclampsia Screen, Proprietary Risk Score

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Billing Code Overview

OpenPayer

CPT 0243U: PlGF Preeclampsia Screen, Proprietary Risk Score

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References