Summary & Overview
CPT 0274U: Versiti Comprehensive Platelet Disorder Panel, NGS
CPT code 0274U designates the Versiti™ Comprehensive Platelet Disorder Panel, a Proprietary Laboratory Analyses (PLA) test using next-generation sequencing of 62 genes plus duplication/deletion analysis of the PLAU gene. The panel is designed to support differential diagnosis of thrombocytopenia and other platelet function disorders and to assess familial risk for inherited platelet conditions. As a PLA code, 0274U is specific to a single manufacturer and test and flags assays with proprietary methodology.
Key payers considered in national coverage discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. This publication summarizes clinical context for molecular platelet disorder testing, payer coverage considerations, and operational benchmarks relevant to laboratories and billing teams.
Readers will find a concise overview of the test and its clinical indications, a summary of common payer approaches and coverage considerations, information on typical sites of service and specimen types, and a list of common billing modifiers used with laboratory molecular testing. The report also highlights coding implications tied to PLA status and next-generation sequencing methodology. Data not available in the input for specific payer policies, pricing benchmarks, associated taxonomies, and ICD-10 diagnoses are noted as unavailable.
Billing Code Overview
CPT code 0274U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to the Versiti™ Comprehensive Platelet Disorder Panel produced by Versiti™ Diagnostic Laboratories. The test uses next-generation sequencing (NGS) of 62 genes plus duplication/deletion analysis of the PLAU gene. It is intended to aid in the differential diagnosis of thrombocytopenia and other platelet function disorders and to evaluate familial risk for inherited platelet conditions.
Service Type: Molecular genetic testing / Proprietary laboratory assay
Typical Site of Service: Clinical laboratory or reference diagnostic laboratory; specimens collected in outpatient clinics, hospitals, or prenatal settings
Clinical & Coding Specifications
Clinical Context
A 28-year-old patient presents to a hematology clinic with a history of chronic mucocutaneous bleeding, easy bruising, and a family history of thrombocytopenia. Initial CBC shows persistently low platelet counts with otherwise normal indices. The hematologist orders genetic testing to evaluate inherited platelet disorders and to guide differential diagnosis between immune-mediated thrombocytopenia, congenital thrombocytopenia, and platelet function defects. A blood draw is performed in the outpatient phlebotomy area and the specimen is sent to Versiti Diagnostic Laboratories for the Versiti™ Comprehensive Platelet Disorder Panel. The sample may alternatively be collected as a buccal swab when venipuncture is not feasible, or as amniotic fluid when prenatal familial risk assessment is requested. Results from next-generation sequencing of 62 genes and duplication/deletion analysis of the PLAU gene are returned to the ordering clinician, who integrates molecular findings with clinical and laboratory data to inform diagnosis, family counseling, and potential cascade testing of relatives.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Service performed; default reporting code | Rarely used as a modifier; use per payer if required to indicate standard service |
22 | Increased procedural services | Applicable if test required substantially greater resources due to complexity (rare for PLA) |
26 | Professional component | Use when only the professional interpretation/reporting component is billed separately |
52 | Reduced services | Use when testing is partially performed or limited relative to full panel |
53 | Discontinued procedure | Use if specimen collection or testing discontinued for documented clinical reasons |
62 | Two surgeons or co-surgeons | Generally not applicable; included only if surgical specimen collection involved with co-surgeons |
78 | Unplanned return to operating/procedure room | Not typically applicable to lab testing |
80 | Assistant surgeon | Not applicable to laboratory PLA testing |
82 | Assistant surgeon when qualified resident not available | Not applicable to PLA testing |
TC | Technical component | Use when billing only the technical lab component (instrumentation, reagents) separate from professional interpretation |
QK | CLIA waived testing performed by physician office | Rare for NGS PLA; include only for payer-specific reporting |
QX | CLIA waived testing, performed by a non-physician | Rarely applicable |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RH0000X | Hematology | Hematologists order and interpret platelet genetic panels |
207L00000X | Pathology | Molecular pathology laboratories perform NGS testing and result validation |
2080P0207X | Medical Genetics | Clinical geneticists provide interpretation for inherited platelet disorders |
363L00000X | Clinical Laboratory | Clinical laboratory directors and molecular diagnosticians oversee testing |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
D69.6 | Thrombocytopenia, unspecified | Common indication for platelet disorder genetic testing when platelet counts are low without clear etiology |
D69.0 | Allergic purpura (Henoch-Schönlein purpura) | May present with thrombocytopenia or platelet dysfunction prompting evaluation |
D69.5 | Secondary thrombocytopenia | Used when an acquired cause is suspected and genetic testing may be used to exclude inherited forms |
D69.3 | Immune thrombocytopenic purpura | Genetic testing can be ordered when clinical features or family history suggest inherited platelet disorder rather than ITP |
R79.1 | Abnormal coagulation profile | Abnormal hemostasis testing may trigger genetic platelet disorder evaluation |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
81211 | BRCA1 sequencing; full gene sequence analysis | Not directly related but represents another high-complexity NGS hereditary panel workflow; exemplifies sequencing methodology similar to gene panels |
81479 | Unlisted molecular pathology procedure | Used when no specific PLA code exists for a test; not applicable when 0274U is reported |
80999 | Unlisted chemistry procedure | May be used historically for novel assays prior to PLA assignment; not used when 0274U is reported |
0000U | Proprietary Laboratory Analysis (example format) | Illustrative of PLA series coding structure; 0274U is the unique PLA code for the Versiti panel |
G0452 | Pharmacogenomic testing (example) | Represents ancillary genomic testing services that may be ordered concurrently for medication management |