Summary & Overview
CPT 0311U: Accelerate PhenoTest BC Kit, Rapid AST (MIC)
CPT code 0311U designates the Accelerate PhenoTest® BC kit AST configuration, a proprietary laboratory assay that produces rapid antimicrobial susceptibility testing (AST) reported as minimum inhibitory concentrations (MIC) for positive blood cultures. Its PLA status means the code is restricted to a single manufacturer’s test, reflecting advanced diagnostic capability for timely guidance on antimicrobial therapy. Nationally, rapid AST platforms like this influence hospital antimicrobial stewardship, sepsis management, and laboratory workflows by shortening time to targeted therapy.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the code’s clinical purpose and service setting, coverage context across major national payers, and the types of analysis typically provided alongside PLA codes: billing benchmarks, coding guidance considerations, and clinical context for use in bloodstream infection management. The publication summarizes payer coverage patterns and common modifiers used with laboratory PLA codes, highlights where policy updates may affect reimbursement and documentation, and outlines the operational implications for hospital and reference laboratories. Data not available in the input will be identified as such when relevant.
Billing Code Overview
CPT code 0311U is a Proprietary Laboratory Analyses (PLA) code that applies specifically to the Accelerate PhenoTest® BC kit, AST configuration from Accelerate Diagnostics Inc. The code reports rapid antimicrobial susceptibility testing (AST) results expressed as minimum inhibitory concentration (MIC) values for organisms detected in positive blood cultures. MIC denotes the lowest concentration of an antimicrobial agent that inhibits microorganism growth.
Service type: Laboratory diagnostic test — rapid antimicrobial susceptibility testing (AST)
Typical site of service: Clinical laboratory processing positive blood cultures
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A hospitalized adult patient presents with fever, hypotension, and signs of sepsis. Blood cultures obtained from peripheral venipuncture and from the patient’s central venous catheter become positive for Gram-negative bacilli on culture. The hospital laboratory performs rapid organism identification with an existing platform (for example, MALDI-TOF or a molecular blood culture ID system) and needs rapid phenotypic antimicrobial susceptibility results reported as minimum inhibitory concentrations (MICs) to guide timely antimicrobial stewardship and targeted therapy. The laboratory uses the Accelerate PhenoTest® BC kit in the AST configuration to generate MIC values directly from the positive blood culture. The clinical workflow includes: initial blood culture incubation and detection, rapid organism identification on the existing ID system, performance of the Accelerate PhenoTest® BC kit AST run (reportable under CPT 0311U), verification of results by clinical microbiology staff, and timely electronic reporting of MICs to the treating clinical team for antibiotic selection. Typical site of service is an acute care hospital clinical laboratory or independent clinical laboratory performing inpatient infectious disease testing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Standard professional and technical components bundled | Use when no separate component reporting is needed; general default reporting behavior. |
26 | Professional component | Use when only the professional (interpretive) component is billed separately by a physician or qualified laboratory director. |
TC | Technical component | Use when only the technical component (laboratory performance, equipment, reagents) is billed by the performing lab. |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure | Generally not applicable; include only if a documented return to procedure is required in unusual workflow. |
82 | Assistant not available when one is normally required | Rare for lab tests; may be used in specific institutional billing rules when assistant modifier policies affect ancillary services. |
90 | Reference (outside) laboratory | Not in provided list. Data not available in the input. |
QK | CLIA-waived test performed in a waived facility | Use if applicable for waived testing circumstances; typically not applicable to PLA AST like 0311U. |
QX | CLIA-waived test performed by a nonwaived provider | Use only when specific CLIA circumstances apply. |
QY | CLIA-waived test performed under provider oversight | Use when regulatory billing rules require CLIA-specific modifier reporting. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services | Use when those nonphysician providers bill for professional interpretation if applicable by payer policy. |
CO | Services related to a worker’s compensation case | Use when the specimen/test is billed under a worker’s compensation claim. |
CQ | Service or procedure furnished as part of a clinical research study | Use when the test is billed under a research protocol with payer acceptance. |
FY | Information not in the provided list. Data not available in the input. | |
TG | Item or service furnished under a grant | Use when testing is paid via grant funding and payer accepts this modifier. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207L00000X | Infectious Disease | Physicians who interpret and act on susceptibility results; oversight of antimicrobial therapy. |
| 207RP1001X | Clinical Pathology | Pathologists responsible for laboratory interpretation and reporting of microbiology AST. |
| 362A00000X | Clinical Laboratory | Clinical laboratory scientists and directors who perform and validate the Accelerate PhenoTest® BC assay. |
| 208D00000X | Emergency Medicine | Emergency physicians who may initiate empiric therapy and use rapid MIC results for inpatient decision-making. |
| 206Q00000X | Critical Care Medicine | Intensivists who use rapid AST MIC data to tailor therapy for septic ICU patients. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
A41.9 | Sepsis, unspecified organism | Common indication for blood cultures and for rapid AST to guide targeted therapy. |
A41.5 | Sepsis due to other Gram-negative bacteria | Directly relevant when Gram-negative bacteremia requires MIC results for antibiotic selection. |
B96.2 | Escherichia coli [E. coli] as the cause of diseases classified elsewhere | If E. coli is identified, AST by 0311U provides MICs for therapeutic choice. |
B96.51 | Klebsiella pneumoniae as the cause of diseases classified elsewhere | Relevant when Klebsiella spp. are the bloodstream isolates requiring susceptibility MICs. |
R65.21 | Severe sepsis with septic shock | Typical high-acuity scenario where rapid MIC reporting impacts critical care antibiotic management. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
87070 | Culture, bacterial, blood, isolation and presumptive identification of isolates | Performed when blood cultures are set up and isolates are recovered; precedes or runs in parallel with rapid ID and AST. |
87798 | Infectious agent detection by nucleic acid (unlisted), multiplex or single-target (used historically for some rapid ID tests) | Represents molecular ID tests that may be used alongside 0311U for organism identification prior to phenotypic AST reporting. |
87471 | Infectious agent detection by nucleic acid (single target) | Used for targeted rapid identification assays that can complement MIC reporting from 0311U. |
87075 | Culture, blood, identification, cultured isolate | Performed when conventional isolate identification is done; can be used when confirmatory culture-based methods are required in addition to rapid AST. |
99000 | Handling and/or conveyance of specimen (used historically; payer-specific) | Used in some workflows for special specimen handling fees when transporting positive blood culture material to a reference lab performing 0311U if applicable. |