Summary & Overview
CPT 0271U: Congenital Neutropenia Panel, 24-gene NGS
CPT code 0271U identifies the Versiti™ Congenital Neutropenia Panel, a proprietary next–generation sequencing (NGS) test analyzing 24 genes linked to congenital neutropenia. As a PLA code, it applies only to the specific test from Versiti™ Diagnostic Laboratories and signals a targeted genetic diagnostic service that can influence clinical decision-making for symptomatic patients and familial risk assessment. Nationally, proprietary genetic test codes are important for claims processing, payer policy development, and transparency around lab-specific services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for congenital neutropenia testing, the service setting and specimen types, and what to expect in terms of code specificity due to the PLA designation. The publication also outlines typical payer considerations, common modifiers associated with molecular laboratory services, and where to look for policy updates affecting coverage and billing for single-source laboratory tests. This summary equips billing managers, lab directors, and policy analysts with the foundational information needed to interpret the code’s role in national billing and reimbursement workflows.
Billing Code Overview
CPT code 0271U is a Proprietary Laboratory Analyses (PLA) code for the Versiti™ Congenital Neutropenia Panel performed by Versiti™ Diagnostic Laboratories. The test uses next–generation sequencing (NGS) of 24 genes associated with congenital neutropenia and may aid clinicians in diagnosing symptomatic patients or evaluating familial risk for inherited conditions.
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Service type: Molecular genetic diagnostic testing using NGS for a targeted multigene panel
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Typical site of service: Clinical laboratory setting; specimens accepted include blood, buccal swab, or amniotic fluid
Clinical & Coding Specifications
Clinical Context
A pediatric or adult patient presents with chronic or recurrent neutropenia, severe bacterial infections, delayed wound healing, or a family history suspicious for inherited neutropenia. The ordering clinician (pediatric hematologist, clinical geneticist, or hematopathologist) documents recurrent low absolute neutrophil counts (ANC) on serial complete blood counts and requests genetic testing to identify pathogenic variants associated with congenital neutropenia. A peripheral blood specimen is collected (or buccal swab / amniotic fluid when indicated for prenatal or familial testing) and sent to Versiti™ Diagnostic Laboratories. The laboratory performs next-generation sequencing (NGS) of a 24-gene panel targeting genes implicated in congenital neutropenia. Results are returned with variant classifications (pathogenic, likely pathogenic, VUS, benign) and interpreted in the context of the clinical phenotype to aid diagnosis, inform prognosis, guide therapy (for example, G-CSF responsiveness), and support familial risk assessment and cascade testing. Typical sites of service include outpatient specialty clinics, hospital outpatient infusion centers, genetics clinics, and hospital inpatient wards when testing is performed for diagnostic clarification during hospitalization.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no separate modifier applies |
22 | Increased procedural services | When test requires substantially greater resources or complexity beyond typical processing (rare for PLA but may apply to extensive additional interpretation) |
26 | Professional component | When a separate professional interpretation component is billed by the laboratory director or pathologist (if payer requires split billing) |
52 | Reduced services | When the specimen is inadequate or testing was partially completed and a reduced service is reported |
53 | Discontinued procedure | If testing was begun but could not be completed for clinical or technical reasons |
62 | Two surgeons / co-surgeons | Not generally applicable; included only when another provider shares substantial responsibility for specimen procurement in complex procedures |
80 | Assistant surgeon | Not typically applicable to laboratory testing; used if an assistant performed specimen procurement tied to billing |
82 | Assistant surgeon (when qualified assistant not available) | Rarely applicable; analogous to 80 for specimen procurement scenarios |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant-at-surgery | Applicable only if advanced practice clinicians are involved in specimen collection in contexts requiring that modifier |
TC | Technical component | When reporting only the laboratory technical testing component and another entity bills the professional interpretation |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RH0000X | Hematology | Ordering and interpreting specialists for neutropenia evaluation |
| 207K00000X | Clinical Molecular Genetics | Laboratories and clinicians specializing in genetic testing and interpretation |
| 2080P0210X | Pediatrics | Pediatric hematologists who manage congenital neutropenia |
| 2085R0201X | Clinical Pathology | Laboratory directors and pathologists responsible for test validation and reporting |
| 207L00000X | Medical Genetics | Clinical geneticists counseling patients and families on inherited neutropenia |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
D70.9 | Neutropenia, unspecified | Common presenting diagnosis prompting genetic testing for congenital causes of neutropenia |
D70.0 | Congenital neutropenia | Directly indicates the inherited condition this panel targets |
D61.9 | Aplastic anemia, unspecified | Differential diagnosis for neutropenia; genetic testing may assist in distinguishing inherited marrow failure syndromes |
Z14.0 | Genetic carrier; autosomal recessive carrier | Used when documenting carrier testing or familial risk assessment related to identified variants |
Z31.5 | Genetic counseling and testing for family planning | Relevant for prenatal or preconception testing when a familial pathogenic variant is known |
R50.9 | Fever, unspecified | Clinical manifestation of infection in neutropenic patients prompting diagnostic evaluation |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
87635 | Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus), amplified probe technique | Data not available in the input. |
0000U | Proprietary laboratory analysis (example PLA placeholder) | Data not available in the input. |
81162 | Exon or targeted region sequencing (e.g., targeted multigene panel) | Commonly performed alongside PLA testing when broader or confirmatory sequencing is required; may be used by other labs reporting component-based NGS panels |
81479 | Unlisted molecular pathology procedure | Used when a specific proprietary test lacks a direct CPT equivalent in non-PLA contexts; may be used for unique or temporary reporting |
0018U | Proprietary laboratory analysis (another PLA) | Data not available in the input. |