Summary & Overview

CPT 0275U: Versiti Heparin–Induced Thrombocytopenia Evaluation – PEA

CPT code 0275U denotes a proprietary laboratory assay: the Versiti Heparin–Induced Thrombocytopenia Evaluation – PEA, a serum‑based platelet P‑selectin expression assay performed by flow cytometry to detect heparin‑dependent platelet antibodies. As a PLA code, 0275U maps to a single manufacturer‑specific test and is used for diagnostic evaluation of suspected Heparin‑Induced Thrombocytopenia/Thrombosis (HIT/HITT). This specificity matters nationally because PLA codes identify unique tests whose availability, pricing, and clinical adoption can affect diagnostic pathways for a high‑risk condition.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the assay, typical sites of service, and which payers are relevant for coverage considerations. The publication provides benchmarks and policy discussion related to proprietary laboratory analyses, operational implications for clinical laboratories and ordering clinicians, and the coding guidance needed to report this unique test correctly. Data not available in the input is noted where applicable, and the focus remains national in scope without state‑level detail.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0275UCPTProprietary Laboratory AnalysisHeparin-Induced ThrombocytopeniaPlatelet P-selectin Expression AssayFlow CytometryDiagnostic LaboratoryPLA code

Billing Code Overview

CPT code 0275U is a Proprietary Laboratory Analyses (PLA) code for the Versiti™ Heparin–Induced Thrombocytopenia Evaluation – PEA. The code applies only to the specific laboratory test performed by Versiti™ Diagnostic Laboratories using a serum specimen for the platelet P–selectin expression assay (PEA) by flow cytometry to detect heparin‑dependent platelet antibodies. This laboratory test can aid in the diagnosis of Heparin‑Induced Thrombocytopenia/Thrombosis (HIT or HITT).

Service type: Proprietary laboratory diagnostic test (PLA) by flow cytometry
Typical site of service: Clinical laboratory or reference diagnostic laboratory

Clinical & Coding Specifications

Clinical Context

A 62-year-old hospitalized patient receiving unfractionated heparin for treatment of a deep vein thrombosis develops a new acute drop in platelet count of >50% and clinical concern for thrombosis. The treating hematologist orders specialized laboratory testing to evaluate for heparin-induced thrombocytopenia (HIT). A serum specimen is collected and sent to Versiti™ Diagnostic Laboratories for the proprietary Versiti™ Heparin–Induced Thrombocytopenia Evaluation – PEA (0275U). The laboratory performs the platelet P‑selectin expression assay (PEA) by flow cytometry to detect heparin‑dependent platelet antibodies. Results are reported to the ordering clinician to aid diagnosis and guide anticoagulation management. Typical sites of service include the hospital inpatient laboratory, an outpatient phlebotomy center, or the reference laboratory performing the proprietary assay. Specimen handling follows laboratory rules for serum collection, labeling, and courier transport to the performing laboratory.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the professional interpretation component of the test is billed separately from the technical component.
`TC`	Technical component	Use when only the technical component (laboratory processing) is billed.
`QX`	CLIA-certified laboratory personnel	Use when the service is performed by a CLIA-certified technologist under the ordering laboratory’s authority (applicable for some payer policies).
`QK`	Physician participating in an ACO	Use when reporting by a clinician participating in an accountable care organization if payer requires.
`QY`	Laboratory test performed in a hospital outpatient setting	Use when the test is performed in a hospital outpatient department and payer guidance requires reporting.
`52`	Reduced services	Use when the test is partially performed or limited for clinical reasons and the full service was not provided.
`53`	Discontinued procedure	Use when specimen collection or testing was started but discontinued for reasons beyond control.
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure	Rarely applicable; use only if relevant to a related invasive procedure requiring repeat intraoperative testing workflow.
`80`	Assistant surgeon	Not typically applicable to laboratory-only services; included for compatibility with multi-disciplinary inpatient claims where relevant.
`62`	Two surgeons	Not typically applicable to this lab assay; use only in complex inpatient claims that require dual surgeon reporting.
`23`	Unusual anesthesia	Not applicable to the assay itself; available where anesthesia-related modifiers are reported on the same claim in error or combined billing.
`22`	Increased procedural services	Use when the laboratory documents significantly greater work or complexity beyond typical assay processing, if payer accepts modifier for PLA codes.
`AS`	Patient is the primary payer	Use per payer rules when the patient is the accountable payer source and the modifier is required.
`SH`	Cost-sharing waiver	Use when the performing laboratory waives patient cost-sharing and payer guidance requires this modifier.

Taxonomy Code	Specialty	Notes
207Q00000X	Hematology	Ordering specialty that commonly evaluates and manages suspected HIT and orders specialized HIT assays.
207L00000X	Pathology	Laboratory specialty responsible for interpretation and oversight of specialized coagulation and immunohematology testing.
208000000X	Internal Medicine	Hospitalist or internist who orders the test during inpatient management of thrombotic or hematologic complications.
163W00000X	Clinical Laboratory	Clinical laboratory personnel who perform and report the technical testing; includes flow cytometry technologists.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D69.59`	Other secondary thrombocytopenia	Commonly used when thrombocytopenia from heparin exposure is suspected and further evaluation with `0275U` is ordered.
`D69.5`	Secondary thrombocytopenia, unspecified	Used in documentation of thrombocytopenia in hospitalized patients when HIT is in the differential diagnosis.
`D68.32`	Heparin-induced thrombocytopenia (HIT)	Direct diagnostic code for HIT; the assay `0275U` aids in confirming heparin-dependent platelet antibodies.
`I82.40`	Acute embolism and thrombosis of unspecified deep veins of lower extremity	Represents thrombotic complications that often lead clinicians to evaluate for HIT when occurring during heparin therapy.
`I80.2`	Phlebitis and thrombophlebitis of other deep vessels of lower extremities	Relevant when thrombotic events prompt HIT testing with `0275U`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Commonly performed prior to sending a serum specimen to the reference laboratory for the PEA (`0275U`).
`80053`	Comprehensive metabolic panel	Frequently ordered concurrently for baseline metabolic assessment in hospitalized patients undergoing evaluation for HIT.
`85376`	Heparin/platelet factor 4 (PF4) enzyme immunoassay (EIA) for HIT	Often ordered as an initial, rapid screening test for HIT antibodies; positive or equivocal EIA results may trigger reflex to functional assays like the PEA (`0275U`).
`85379`	Platelet function test, platelet aggregation; multiple electrode impedance aggregometry or flow cytometry platelet function	Other platelet function/flow cytometry tests that may be performed in parallel or by specialized labs when investigating platelet disorders.
`99000`	Handling fee for laboratory specimens or special courier	Administrative or courier charges that may accompany shipment of a specimen to an external reference laboratory performing `0275U`.

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