Summary & Overview

CPT 0281U: Versiti VWF Propeptide Antigen ELISA, Plasma

CPT code 0281U designates a Proprietary Laboratory Analyses (PLA) test for the Versiti™ VWF Propeptide Antigen, an ELISA-based plasma assay performed by Versiti™ Diagnostic Laboratories. This single-source, manufacturer- or lab-specific code identifies a specialized laboratory measure of von Willebrand factor propeptide antigen used in the evaluation of VWF-related disorders and for monitoring VWF biology. National attention to PLA codes like 0281U reflects growing use of highly specific assays tied to a single laboratory or manufacturer and their implications for billing clarity and payer coverage.

Key payers discussed in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the test purpose and clinical context, an outline of service and site-of-service expectations, and what to look for in payer coverage language. The publication highlights typical billing elements and common modifiers used with laboratory assays, and summarizes where to find additional policy detail. Data not available in the input for certain items (for example, associated taxonomies, ICD-10 diagnoses, and related codes) are noted as unavailable.

The report is intended for billing managers, laboratory directors, and policy analysts who need a clear national-level reference for CPT code 0281U, including the clinical indication, laboratory setting, and payer landscape relevant to this proprietary VWF propeptide antigen assay.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0281UCPTProprietary Laboratory Analysesvon Willebrand factorVWF propeptideELISADiagnostic laboratoryLaboratory billingPLA code

Billing Code Overview

CPT code 0281U is a Proprietary Laboratory Analyses (PLA) code for the Versiti™ VWF Propeptide Antigen test performed by Versiti™ Diagnostic Laboratories. The test uses a plasma specimen and an enzyme–linked immunosorbent assay (ELISA) to measure levels of the von Willebrand factor (VWF) propeptide antigen.

Service Type: Laboratory diagnostic assay for VWF propeptide antigen.

Typical Site of Service: Clinical diagnostic laboratory (reference or specialty laboratory) using a plasma specimen.

Clinical & Coding Specifications

Clinical Context

A patient with suspected or known von Willebrand disease (VWD) or acquired von Willebrand syndrome presents for laboratory evaluation of hemostatic function. Typical presentation includes mucocutaneous bleeding (epistaxis, menorrhagia, easy bruising), abnormal preoperative bleeding history, or monitoring after treatment for VWD. A clinician (hematologist or ordering provider) collects a plasma specimen and sends it to Versiti™ Diagnostic Laboratories. Versiti™ VWF Propeptide Antigen testing (0281U) is performed by enzyme–linked immunosorbent assay (ELISA) to quantify von Willebrand factor propeptide levels, which help distinguish reduced VWF synthesis, increased clearance, or acute-phase changes. Results are used alongside VWF antigen, VWF activity (ristocetin cofactor or alternative), FVIII levels, multimer analysis, and clinical history to classify VWD subtype, assess disease severity, or evaluate treatment response. Typical sites of service include outpatient phlebotomy centers, hospital laboratories sending to the reference lab, and specialty hematology clinics coordinating send-out testing. Turnaround time and specimen handling requirements are provided by the laboratory; testing is billed to the payer using the proprietary PLA code 0281U specific to Versiti™ Diagnostic Laboratories.

Coding Specifications

Modifier	Description	When to Use
`00`	Related service performed at the same facility — not a standard CMS modifier but listed in input	Use per payer rules when reporting a lab service with no modifier required; follow payer guidance.
`22`	Increased procedural services	Rarely used for PLA codes; applicable if administrative effort for testing exceeds typical complexity and payer allows reporting for exceptional work.
`26`	Professional component	Use when billing only the professional component of the test separate from technical component, if payer accepts split billing for this PLA.
`52`	Reduced services	Use when the test is partially performed or specimen insufficient and payer permits reduced service reporting.
`53`	Discontinued procedure	Use if test collection or processing was discontinued for clinical reasons prior to completion.
`62`	Two surgeons or providers	Typically not applicable to lab tests; only used if two qualified providers share responsibility per payer policy.
`80`	Assistant surgeon	Not applicable to laboratory PLA testing; include only if payer requires for unique billing situations.
`82`	Assistant surgeon (when qualified resident not available)	Not applicable to lab testing; include per payer exceptions only.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant	Not applicable to lab testing; not typically used for PLA lab codes.
`CO`	Contemporaneous care	Use when another payer is primary/coordination of benefits requires notation; follow payer-specific modifier guidance.
`QK`	Medical direction of two, three, or four technicians/technologists	Use when a physician medically directs multiple lab technologists performing the test and payer requires Q modifiers.
`QX`	Qualified nonphysician performing medical direction of two, three, or four technicians/technologists	Use when an eligible nonphysician directs multiple technicians per payer rules.
`QY`	Medical direction of one technician/technologist	Use when medical direction of a single technician applies and payer policy accepts QY for the lab service.
`TC`	Technical component	Use when billing only the technical component of the test (laboratory processing, reagents, instrumentation).

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology	Hematologists order diagnostic VWF propeptide testing for bleeding disorders and subtype classification.
207K00000X	Hematology & Oncology	Specialists in hematology/oncology evaluate complex coagulation disorders and coordinate reference lab testing.
207L00000X	Pathology	Pathologists direct laboratory test selection and interpretation for coagulation assays and send-out testing.
363L00000X	Laboratory Director	Clinical laboratory directors oversee methodology, quality, and reporting for specialized ELISA assays at reference labs.
233600000X	Clinical Laboratory Technologist	Laboratory technologists perform specimen processing and ELISA testing in the technical component of `0281U`.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`D68.0`	von Willebrand disease	Primary indication for VWF propeptide antigen measurement to subtype VWD and evaluate VWF synthesis vs clearance.
`D69.0`	Allergic purpura (Henoch-Schönlein purpura)	Bleeding or purpura evaluation may include VWF studies when systemic vasculitis or platelet disorders are considered.
`D69.3`	Immune thrombocytopenic purpura (ITP)	Differentiation of platelet-mediated bleeding from VWF-related bleeding can prompt VWF propeptide testing.
`D68.9`	Coagulation defect, unspecified	Used when a nonspecific coagulopathy is being investigated and specialized VWF testing is part of the diagnostic panel.
`N92.0`	Excessive and frequent menstruation with regular cycle	Menorrhagia is a common presentation leading to evaluation for VWD including VWF propeptide antigen.
`R04.0`	Epistaxis	Recurrent nosebleeds may trigger hemostasis testing for VWF abnormalities, including propeptide levels.
`Z51.11`	Encounter for antineoplastic chemotherapy	Monitoring VWF parameters may occur in oncology patients with bleeding risk or treatment-related coagulopathy; VWF propeptide can help assess acquired VWF changes.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86900`	Evaluation of a patient for specific antibody; qualitative or semiquantitative, each test	May be ordered alongside serologic assays when immune-mediated causes are considered; often part of broader hemostasis workup.
`85241`	Von Willebrand factor assay	VWF antigen/activity assays are commonly performed with VWF propeptide (`0281U`) to assess VWF quantity and function.
`85384`	Coagulation factor activity assay (Factor VIII)	Factor VIII activity is frequently measured with VWF testing because VWF stabilizes FVIII; used in differential diagnosis and management.
`85330`	Platelet function analysis (e.g., aggregometry)	Performed when platelet function defects are considered in differential diagnosis of mucocutaneous bleeding alongside VWF studies.
`86140`	Quantitative antigen assay, each (e.g., ELISA)	General CPT for quantitative antigen assays; laboratories may perform ancillary quantitative assays in the coagulation panel.