Summary & Overview
CPT 0272U: Versiti Comprehensive Bleeding Disorder Panel, NGS Genetic Test
CPT code 0272U designates the Versiti™ Comprehensive Bleeding Disorder Panel, a Proprietary Laboratory Analyses (PLA) test that uses next-generation sequencing of 60 genes plus PLAU duplication/deletion analysis to evaluate inherited bleeding disorders. The code is specific to a single manufacturer/laboratory offering and captures a multi-gene molecular diagnostic service that can inform differential diagnosis in symptomatic patients and familial risk assessment. Nationally, PLA codes like 0272U matter because they identify vendor-specific tests with distinct clinical value and billing considerations compared with non-proprietary molecular panels. Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical scope of the panel, typical sites of service and specimen types, the payer landscape covered by the analysis, and practical coding context such as applicable modifiers (list provided separately). The publication summarizes benchmarks and policy-relevant issues for proprietary molecular diagnostics, outlines common administrative considerations for laboratory billing, and provides a concise clinical context to support coding accuracy and payer communication. Data not available in the input for taxonomies, specific ICD-10 pairings, related codes, or payer-specific coverage policies is noted where applicable.
Billing Code Overview
CPT code 0272U is a Proprietary Laboratory Analyses (PLA) code for the Versiti™ Comprehensive Bleeding Disorder Panel performed by Versiti™ Diagnostic Laboratories. The test uses next-generation sequencing (NGS) to analyze 60 genes associated with inherited bleeding disorders that affect platelet function or the coagulation cascade, and it includes duplication/deletion analysis of the PLAU gene.
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Service type: Clinical genetic testing using NGS with targeted gene sequencing and copy-number (duplication/deletion) analysis for a specified proprietary panel.
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Typical site of service: Clinical laboratory; specimens may include blood, buccal swab, or amniotic fluid.
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Clinical purpose: The panel aids in differential diagnosis for symptomatic patients and in evaluation of familial risk for inherited bleeding conditions.
Clinical & Coding Specifications
Clinical Context
A symptomatic patient with unexplained mucocutaneous bleeding, easy bruising, heavy menstrual bleeding, recurrent epistaxis, or a family history of inherited bleeding disorders is evaluated. A hematologist orders the Versiti™ Comprehensive Bleeding Disorder Panel (0272U) to identify pathogenic variants in 60 genes associated with platelet function and coagulation, and to detect PLAU gene duplication/deletion. Specimen types include peripheral blood, buccal swab, or amniotic fluid. The clinical workflow: initial clinical assessment and coagulation screening tests (CBC, PT/INR, aPTT, fibrinogen, platelet function assays) are performed; if results are inconclusive or genetic confirmation/ familial risk assessment is needed, the provider obtains informed consent for genetic testing, collects the specimen, and sends it to Versiti™ Diagnostic Laboratories. Results are reviewed by the ordering clinician and incorporated into diagnosis, counseling, family testing decisions, and treatment planning (including periprocedural management and targeted therapies). Typical site of service is an outpatient clinic, hospital outpatient laboratory, or specialized genetic testing laboratory facility. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA plans, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional component (interpretation) provided by the laboratory director or pathologist separate from the technical testing. |
TC | Technical component | Use when billing only the technical component (performed testing, instrumentation, specimen processing) by the performing lab. |
QX | Qualified nonphysician practitioner | Use when a qualified nonphysician practitioner performs or orders elements of the service under appropriate supervision or rules. |
QY | Location of service - hospital outpatient | Use when the service is furnished in a hospital outpatient clinic setting (per payer policy). |
AS | Physician assistant, nurse practitioner, clinical nurse specialist services for assistant at surgery | Rarely applicable; use only if an advanced practitioner is billing a relevant component per payer rules. |
22 | Increased procedural services | Use when the laboratory documents a substantially greater level of work or complexity beyond typical testing (rare for PLAs but applicable if extensive additional analysis documented). |
52 | Reduced services | Use when the test is partially performed or a limited panel is completed versus the full PLA, with documentation. |
59* | Data not listed among provided modifiers | Data not available in the input. |
78 | Return to operating room for a related procedure | Not typically applicable; included in list of potential modifiers for surgical contexts but seldom used for lab PLAs. |
80 | Assistant surgeon | Not typically applicable; included for completeness when advanced personnel are involved in surgical specimen acquisition. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2080S0005X | Hematology | Hematologists commonly order and interpret genetic bleeding disorder panels. |
| 208000000X | Medical Genetics | Medical geneticists provide diagnostic interpretation and counseling for inherited bleeding disorders. |
| 207RC0000X | Pathology | Molecular pathology specialists oversee next-generation sequencing testing and result validation. |
| 363L00000X | Laboratory | Clinical laboratory specialists and molecular diagnostic lab directors manage specimen processing and reporting. |
| 207K00000X | Pediatrics | Pediatric hematologists evaluate congenital bleeding disorders and may order panel testing. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
D69.3 | Immune thrombocytopenic purpura | Genetic panel may help exclude inherited platelet function defects when autoimmune causes are considered. |
D69.5 | Secondary thrombocytopenia | Used when thrombocytopenia is present and genetic causes are evaluated in differential diagnosis. |
D68.4 | Von Willebrand disease | Common inherited bleeding disorder; molecular testing can clarify subtype or alternative diagnoses. |
D68.9 | Coagulation defect, unspecified | Used when a coagulation disorder is suspected and comprehensive genetic testing is ordered. |
N92.4 | Excessive bleeding in the puerperium | Peripartum bleeding may prompt genetic evaluation for inherited coagulation defects affecting management. |
R58 | Hemorrhage, not elsewhere classified | Unexplained significant bleeding prompting comprehensive genetic analysis. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
82948 | Glucose; blood, reagent strip | Data not available in the input. |
36415 | Collection of venous blood by venipuncture | Commonly performed prior to sending specimen for the 0272U genetic test; documents specimen collection. |
81479 | Unlisted molecular pathology procedure | May be used historically for novel or complex molecular tests prior to PLA assignment; replaced by specific PLA 0272U. |
88381 | Immunohistochemistry or special stains, interpretation | Data not available in the input. |
81225 | CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis | Data not available in the input. |
Note: If a related code list was not provided in the input, clinical practice commonly pairs 0272U with specimen collection codes such as 36415 and with other molecular or genetic counseling services; however, only codes listed above are included per input constraints.