Summary & Overview
CPT 0305U: Ektacytometry for Red Blood Cell Deformability
CPT code 0305U designates a Proprietary Laboratory Analyses (PLA) test for Ektacytometry performed by BioChip Labs™. The assay evaluates red blood cell deformability using a whole blood specimen and measures elongation under shear stress. As a PLA code, 0305U is specific to one manufacturer's unique test and signals a specialized diagnostic service in hematology.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of the code’s clinical context, how it fits into laboratory service lines, and which major payers recognize the test for coverage considerations. The publication outlines expected sites of service and service type for coding and billing workflows and summarizes common modifiers associated with laboratory procedures.
The report provides benchmarks and payer coverage patterns, highlights policy implications for proprietary laboratory tests, and situates CPT code 0305U within diagnostic testing pathways for disorders affecting red blood cell deformability. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0305U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to a single, manufacturer-specific test: Ektacytometry from BioChip Labs™. The assay uses a whole blood specimen to evaluate red blood cell (RBC) deformability, measuring elongation of RBCs under shear stress (force parallel to the cell surface).
Service Type: Laboratory — specialized hematology diagnostic test
Typical Site of Service: Clinical laboratory or reference diagnostic laboratory
Clinical & Coding Specifications
Clinical Context
A 12-year-old child with chronic hemolytic anemia is evaluated for red blood cell membrane disorders after intermittent jaundice, episodic splenomegaly, and a family history of hereditary spherocytosis. The hematologist orders an ektacytometry assay to assess RBC deformability using a whole blood specimen sent to BioChip Labs™. The specimen is collected in an appropriate anticoagulant tube, labeled, and shipped per the laboratory’s instructions. Results report RBC elongation indices across shear stresses to help distinguish membrane and cytoskeletal defects (for example, hereditary spherocytosis, hereditary elliptocytosis, and other congenital hemolytic anemias) from other causes of hemolysis. The clinical workflow includes: ordering the proprietary test (0305U) in the electronic medical record; obtaining informed consent if required; phlebotomy in an outpatient clinic, inpatient ward, or specialty hematology clinic; specimen packaging and shipment to BioChip Labs™; laboratory analysis by ektacytometry; and return of a diagnostic report to the ordering hematologist for correlation with peripheral smear, osmotic fragility tests, molecular testing, and clinical findings.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if split billing applies. |
| Reduced services | Use when the test is partially completed or performed at a reduced level.