Summary & Overview
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 & Coding Specifications
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 |
|---|---|---|
00 |