Summary & Overview
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.
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.
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Service type: Laboratory diagnostic test that quantifies PlGF and produces a proprietary risk score for preeclampsia
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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 |