Summary & Overview
CPT 0442U: FebriDx Bacterial/Non-Bacterial Point-of-Care Assay
CPT code 0442U is a PLA code for the FebriDx® Bacterial/Non–Bacterial Point–of–Care Assay from Lumos Diagnostics LLC. The assay uses a fingerstick whole–blood specimen to detect Myxovirus resistance protein A (MxA) and C–reactive protein (CRP) to help distinguish bacterial from non-bacterial respiratory infections. As a PLA code, 0442U represents a single proprietary test tied to a specific manufacturer and is used for tracking, billing, and policy decisions for this unique diagnostic tool.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The code is relevant nationally for outpatient and point-of-care settings, including urgent care, emergency departments, and primary care clinics where rapid differentiation of bacterial versus non-bacterial respiratory infection can influence diagnostic workflows and antimicrobial stewardship.
Readers will find an overview of the clinical context for the test, the typical sites of service and service type, and the payers covered. The publication summarizes payer coverage considerations, common modifiers associated with billing this PLA code, and practical coding guidance for documentation and claims submission. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 0442U is a Proprietary Laboratory Analyses (PLA) code that applies only to the FebriDx® Bacterial/Non–Bacterial Point–of–Care Assay from Lumos Diagnostics LLC. The test uses a fingerstick whole–blood specimen to assess a patient with signs and symptoms of a respiratory infection to determine whether the source is bacterial by detecting the presence or absence of the biomarkers Myxovirus resistance protein A (MxA) and C–reactive protein (CRP).
Service Type: Point-of-care infectious disease diagnostic assay using fingerstick whole blood
Typical Site of Service: Point-of-care settings such as urgent care clinics, emergency departments, primary care offices, and other outpatient clinics where fingerstick testing is performed
Clinical & Coding Specifications
Clinical Context
A patient presents to an urgent care clinic with acute onset cough, fever, nasal congestion, and myalgias for 48 hours. The clinician performs a focused respiratory exam and documents concern for an acute respiratory infection where distinguishing bacterial from viral etiology will influence antibiotic prescribing. A fingerstick point‑of‑care test, the FebriDx® Bacterial/Non–Bacterial Point–of–Care Assay (0442U), is performed using a capillary whole‑blood specimen. The assay reports presence or absence of Myxovirus resistance protein A (MxA) and C‑reactive protein (CRP) to support differentiation between likely viral versus bacterial infection. Results are available during the visit and are documented in the medical record; the clinician uses the result to guide immediate treatment decisions, patient counseling, and documentation for the encounter. Typical site of service is an urgent care clinic, primary care office, or other ambulatory point‑of‑care setting. Service type is point‑of‑care diagnostic laboratory testing performed at the bedside or in‑clinic with a fingerstick whole‑blood specimen.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default — no modifier | Use when no special billing modifier applies. |