Summary & Overview
CPT 0276U: Versiti Inherited Thrombocytopenia NGS Panel
CPT code 0276U designates the Versiti™ Inherited Thrombocytopenia Panel, a proprietary next-generation sequencing (NGS) assay analyzing 42 genes linked to inherited thrombocytopenia. As a PLA code, 0276U applies to a single, manufacturer- or lab-specific test and signals specialized molecular diagnostics increasingly used for precise genetic diagnosis and familial risk assessment. Nationally, PLA codes like 0276U matter because they standardize billing for unique, high-complexity tests and affect how payers process and cover advanced genomic services.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise factual overview of the code’s clinical purpose, typical service setting, and payer landscape. The publication also outlines common billing modifiers associated with the service and highlights where input data is unavailable. Clinical context covers when the panel is appropriate—differential diagnosis of symptomatic patients and familial risk evaluation—and the assay technology (NGS). Policy and reimbursement readers will gain clarity on the code’s PLA status, implications for claims processing, and considerations for coverage determination at the national level.
Billing Code Overview
CPT code 0276U is a Proprietary Laboratory Analyses (PLA) code for the Versiti™ Inherited Thrombocytopenia Panel performed by Versiti™ Diagnostic Laboratories. The test uses next-generation sequencing (NGS) analysis of 42 genes associated with inherited forms of thrombocytopenia to support differential diagnosis in symptomatic patients or evaluation of familial risk.
Service Type: Genetic diagnostic laboratory test (NGS panel)
Typical Site of Service: Clinical laboratory or outpatient specimen collection site, using specimens such as blood, buccal swab, or amniotic fluid.
Clinical & Coding Specifications
Clinical Context
A symptomatic adult or pediatric patient presents with persistent thrombocytopenia (low platelet count) or unexplained bleeding symptoms, often after initial laboratory evaluation with a complete blood count and peripheral smear. A hematologist evaluates the patient for inherited versus acquired causes of thrombocytopenia. Indications for testing include lifelong or familial history of low platelets, abnormal platelet morphology, poor response to immune therapies, recurrent mucocutaneous bleeding, or counseling for reproductive or family planning when a hereditary platelet disorder is suspected. The clinician orders the Versiti™ Inherited Thrombocytopenia Panel (0276U) when next-generation sequencing (NGS) of 42 genes will aid differential diagnosis and guide genetic counseling.
Specimen collection is commonly a peripheral blood draw; alternatives include buccal swab or amniotic fluid for prenatal/fetal evaluation. The sample is sent to Versiti™ Diagnostic Laboratories. The laboratory performs NGS, analyzes variants in the specified gene set, and provides a report categorizing findings (pathogenic, likely pathogenic, variant of uncertain significance, benign). Results are reviewed by the ordering clinician in the context of clinical phenotype and family history to establish diagnosis, inform management, and support familial testing or genetic counseling referrals. Typical sites of service include hospital outpatient laboratories, specialty hematology clinics, independent diagnostic laboratories, and maternal-fetal medicine settings for prenatal indications.
Coding Specifications
| Modifier | Description | When to Use |
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