CPT 0278U: Versiti Thrombosis Panel, 14-Gene NGS Test

Headline: New PLA CPT code 0278U identifies the Versiti™ Thrombosis Panel, an NGS-based 14-gene test for inherited thrombosis risk.

Lead: CPT code 0278U designates a proprietary next-generation sequencing (NGS) assay—the Versiti™ Thrombosis Panel—used to evaluate inherited thrombophilia by analyzing 14 genes from specimens such as blood, buccal swab, or amniotic fluid. As a PLA code, 0278U applies only to this single manufacturer-specific test, ensuring specificity in billing and claims adjudication.

Why it matters: Genetic testing for thrombosis risk influences diagnostic pathways, familial risk assessment, and preconception or prenatal counseling. A unique PLA code improves clarity for payers and providers, aiding in utilization tracking and coverage determinations at a national level.

Payers covered: The analysis includes major commercial and public payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

What readers will learn: The publication provides benchmarks and context for use of CPT code 0278U, summarizes clinical indications tied to inherited thrombosis testing, outlines typical service settings and specimen types, and highlights the implications of PLA designation for coding accuracy and payer communication. Data not available in the input will be explicitly noted where relevant.

Billing Code Overview

CPT code 0278U is a Proprietary Laboratory Analyses (PLA) code assigned to the Versiti™ Thrombosis Panel from Versiti™ Diagnostic Laboratories. The test uses next-generation sequencing (NGS) analysis of 14 genes associated with thrombosis risk to aid in diagnosis or evaluation of familial risk for inherited thrombophilia. Report 0278U only for the Versiti™ Thrombosis Panel performed by Versiti™ Diagnostic Laboratories using specimens such as blood, buccal swab, or amniotic fluid.

Service type: Genetic diagnostic testing using next-generation sequencing (NGS)

Typical site of service: Clinical laboratory or diagnostic laboratory setting

Clinical Context

A 32-year-old woman with a strong family history of venous thromboembolism is referred to a hematology clinic for evaluation of inherited thrombophilia prior to pregnancy planning. She has a personal history of a provoked deep vein thrombosis after oral contraceptive use at age 28. The clinician orders the Versiti™ Thrombosis Panel (0278U), which is a next-generation sequencing (NGS) test performed by Versiti™ Diagnostic Laboratories using blood, buccal swab, or amniotic fluid.

Specimen collection is arranged in the outpatient phlebotomy lab; the ordered test is requisitioned through the laboratory portal and shipped to the performing laboratory with a chain-of-custody and requisite patient identifiers. Results return to the ordering hematologist within the laboratory’s stated turnaround time and include pathogenic, likely pathogenic, and variant of uncertain significance findings across 14 genes associated with thrombosis risk. The clinician reviews results in a follow-up visit to discuss implications for anticoagulation, family testing, and reproductive counseling. Documentation includes indication, specimen type, informed consent for genetic testing, the specific PLA code 0278U, and result interpretation in the medical record.

Coding Specifications

Modifier	Description	When to Use
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Taxonomy Code	Specialty	Notes
207RH0000X	Hematology	Hematologists commonly order and interpret thrombophilia genetic testing.
207K00000X	Medical Genetics	Clinical geneticists or genetic counselors coordinate testing and variant interpretation.
208D00000X	Obstetrics & Gynecology	OB/GYNs order testing for preconception or pregnancy risk assessment.
363L00000X	Clinical Laboratory	Laboratory directors and molecular pathology specialists oversee NGS testing operations.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I82.40`	Acute embolism and thrombosis of unspecified deep veins of lower extremity	Indicative of venous thromboembolism prompting thrombophilia evaluation.
`D68.51`	Factor V Leiden mutation	Specific inherited thrombophilia that may be detected or evaluated in a thrombosis gene panel.
`D68.52`	Prothrombin gene mutation (G20210A)	Common inherited mutation evaluated within thrombosis genetic testing.
`Z15.01`	Genetic susceptibility to other disease; family history of: thrombophilia	Used for family risk assessment and carrier evaluation.
`O09.89`	Supervision of high-risk pregnancy, other specified condition	Used when testing is performed as part of preconception or prenatal risk assessment related to thrombosis.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81025`	Urinalysis, by dip stick or tablet reagent; non-automated, with microscopy	May be ordered concurrently for baseline evaluation but not directly related to NGS thrombosis panel.
`36415`	Collection of venous blood by venipuncture	Commonly performed to obtain the blood specimen submitted for the `0278U` test.
`0000U`	Data not specified in input	Data not available in the input.
`G0452`	Pharmacogenomic testing, interpretation and report	May be performed in broader genetic evaluation workflows though not specific to thrombosis NGS testing.
`80307`	Therapeutic drug assay (narrow therapeutic range)	May be ordered downstream if anticoagulant therapy is started and drug monitoring is required.

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Summary & Overview