Summary & Overview

CPT 0371U: Qlear UTI Multiplex Urine Molecular Test

CPT code 0371U identifies a Proprietary Laboratory Analyses (PLA) assay for Qlear UTI, a multiplex amplified-probe molecular test that detects one fungal and 16 bacterial organisms in urine specimens associated with urinary tract infections. As a PLA code, 0371U applies uniquely to the Qlear UTI test produced by Lifescan Labs of Illinois, Thermo Fisher Scientific. Its PLA status signals a single-source, manufacturer- or lab-specific service that is tracked separately from general molecular panels.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise overview of the clinical purpose of the test, typical site-of-service expectations, and the national relevance of PLA coding for proprietary diagnostics. The publication outlines billing and coverage considerations commonly affecting PLA codes, summarizes typical payer approaches, and provides context for coding fidelity and claim submission. Information on available benchmarks, payer policy variations, and related reimbursement trends is presented where available. Data not available in the input will be identified as such rather than inferred.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0371UCPTProprietary Laboratory Analysesmolecular diagnosticurine culture alternativeUTI testinglaboratorymultiplex PCRclinical diagnostics

Billing Code Overview

CPT code 0371U is a Proprietary Laboratory Analyses (PLA) code specific to a single commercial test: Qlear UTI from Lifescan Labs of Illinois, Thermo Fisher Scientific. The code describes a laboratory assay that evaluates a urine specimen using a multiplex amplified probe technique to detect the presence of one fungal organism or any of 16 bacterial organisms that may cause urinary tract infections.

Service type: Laboratory — molecular diagnostic test

Typical site of service: Clinical laboratory or outpatient collection site (urine specimen collection with laboratory processing)

Clinical & Coding Specifications

Clinical Context

A 28-year-old female presents to an outpatient primary care clinic with dysuria, urinary frequency, and suprapubic discomfort for 48 hours after intermittent episodes of similar symptoms. A clean-catch urine specimen is collected and sent to the laboratory for molecular testing to identify bacterial or fungal pathogens causing urinary tract infection. The clinic uses the proprietary assay 0371U (Qlear UTI from Lifescan Labs of Illinois, Thermo Fisher Scientific), which applies a multiplex amplified probe technique to detect one fungal species and 16 bacterial organisms associated with UTI. The specimen is transported to the performing laboratory, processed on an automated platform, and results are returned electronically to the ordering clinician within the test’s turnaround time. Results guide selection of targeted antimicrobial therapy and influence decisions about urine culture, additional susceptibility testing, or referral to urology for complicated or recurrent infections.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier required; default reporting	Use when no special circumstance applies to the service.
`26`	Professional component	Use when billing for only the professional component (interpretation) if separated from technical component.
`TC`	Technical component	Use when billing for only the technical component (laboratory processing) if the performing lab bills separately.
`52`	Reduced services	Use if the test is partially performed or limited compared with full assay protocol.
`53`	Discontinued procedure	Use if specimen processing was started but the test was discontinued for clinical reasons.
`54`	Surgical care only (rare for labs)	Generally not applicable; included when organizational billing requires split of care.
`55`	Postoperative management only	Generally not applicable for this assay; may be used in complex care billing scenarios.
`62`	Two surgeons (not typical for lab)	Not typically used; included when facility billing systems list it for completeness.
`78`	Return to the operating room (related to prior procedure)	Not applicable to this lab test except in exceptional perioperative specimen handling.
`80`	Assistant surgeon	Not applicable to laboratory testing; included if billing system requires assistant reporting.
`82`	Assistant not available (when a qualified resident is not available)	Not applicable to this assay.
`QX`	Ordering physician(s) modifier for financial relationships	Use when the ordering practitioner also performs a component subject to QX reporting per payer rules.
`QY`	Ordering laboratory clinical diagnostic laboratory test (specimen pass-through)	Use when the test is performed by a qualified laboratory under the ordering laboratory’s billing arrangement.

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine	Primary care clinicians commonly order UTI molecular diagnostics.
208D00000X	General Practice	Outpatient general practitioners order urine pathogen testing for symptomatic patients.
207L00000X	Obstetrics & Gynecology	OB/GYN clinicians evaluate UTIs in female patients and order molecular assays.
207K00000X	Internal Medicine	Internists manage adult UTIs and order diagnostic testing.
207RH0000X	Emergency Medicine	Emergency clinicians may order rapid molecular UTI testing for acute presentations.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N39.0`	Urinary tract infection, site not specified	Primary diagnosis prompting use of the `0371U` molecular UTI panel to identify causative organisms.
`N30.00`	Acute cystitis without hematuria	Common presentation leading to urine testing with molecular detection for bacteria/fungi.
`N30.9`	Cystitis, unspecified	Clinical scenario where multiplex urine testing helps define pathogen presence.
`N10`	Acute pyelonephritis	More severe infection where rapid identification of organisms can direct therapy.
`N76.0`	Acute vaginitis	Symptoms may overlap with UTI; molecular testing can help differentiate causes when urine is tested.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`87086`	Culture, bacterial; urine, routine, with isolation and presumptive identification	Performed when culture is needed to obtain isolates for antimicrobial susceptibility after molecular detection.
`87088`	Culture, bacterial; urine, quantitative colony count, with isolation and presumptive identification	Used for quantitative assessment when colony counts guide management of complicated UTI.
`87471`	Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique	Example of molecular NAAT testing commonly performed alongside STI testing in genitourinary evaluations.
`87490`	Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms (e.g., multiplex panels), amplified probe technique, each organism	Represents molecular multiplex methodology similar in workflow to `0371U` and may be used for comparison of methodology.
`81002`	Urinalysis, non-automated, without microscopy	Often performed at point of care and precedes molecular testing to assess pyuria or hematuria.