Find policies, billing codes, payers, states, and providers

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.

Customize your policy alerts

Sign up for cpt 0442U policy alerts

Get alerted when payer policies referencing 0442U are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

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

Explore openpayer tools

View all tools

Find policies, billing codes, payers, states, and providers

CPT 0442U: FebriDx Bacterial/Non-Bacterial Point-of-Care Assay

Customize your policy alerts

Sign up for cpt 0442U policy alerts

Get alerted when payer policies referencing 0442U are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

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.
`26`	Professional component	Use when billing only the physician interpretation/professional component separate from the technical component.
`TC`	Technical component	Use when billing only the technical component (test performance/supplies) separate from the professional component.
`QX`	Ordering physician not supervising CLIA-waived testing personnel	Use when the test is performed by personnel under a qualified general supervision model and billing requires the modifier.
`QY`	Physician directing CLIA-waived testing personnel	Use when the physician or other qualified practitioner directs testing personnel under an approved model.
`QK`	Physician performs test personally (specific programmatic contexts)	Use when program rules require indicating the physician personally performed or supervised the test.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	Use when those clinicians provided the service per payer rules and modifier is requested.
`52`	Reduced services	Use when the full test procedure could not be completed or only a partial procedure was performed.
`53`	Discontinued procedure	Use when testing was started but discontinued for patient safety or other valid reason.
`78`	Unplanned return to operating/procedure room	Generally not applicable but may be used if a procedural complication required return for additional testing related to an invasive procedure.
`22`	Increased procedural services	Use when documentation supports substantially greater effort or resources for the testing encounter.
`23`	Unusual anesthesia	Not typically applicable for point‑of‑care testing; included when unusual anesthesia was required during an associated procedure.
`62`	Two surgeons	Not typically applicable; used when two practitioners of the same specialty share responsibility for a procedure.
`QX`	Modifier appears above; duplicate entries should be avoided — use once as appropriate.	Use as above.

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine	Common providers performing point‑of‑care respiratory testing in ambulatory settings.
208D00000X	Emergency Medicine	Urgent care / emergency clinicians frequently use rapid diagnostics for acute respiratory infections.
207L00000X	Internal Medicine	Primary care internists performing in‑office point‑of‑care testing.
363L00000X	Nurse Practitioner	NPs often perform and document point‑of‑care tests in ambulatory clinics.
367A00000X	Physician Assistant	PAs commonly conduct testing and manage acute respiratory encounters.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J06.9`	Acute upper respiratory infection, unspecified	Common presentation where FebriDx may assist in distinguishing viral vs bacterial etiology.
`J02.9`	Acute pharyngitis, unspecified	Pharyngitis evaluation may include point‑of‑care tests to guide antibiotic decisions.
`J20.9`	Acute bronchitis, unspecified	FebriDx can inform likelihood of bacterial involvement in acute bronchitis.
`J18.9`	Pneumonia, unspecified organism	When pneumonia is suspected, FebriDx results may contribute to initial management decisions.
`R05`	Cough	Symptom code frequently present in encounters where rapid differentiation of infection type is desired.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0442U`	FebriDx® Bacterial/Non–Bacterial Point–of–Care Assay — fingerstick whole‑blood test for MxA and CRP	Index PLA code for the point‑of‑care assay used to differentiate bacterial from non‑bacterial respiratory infection.
`36415`	Collection of venous blood by venipuncture	Used if a venous specimen is collected for additional laboratory testing alongside the point‑of‑care fingerstick assay.
`80053`	Comprehensive metabolic panel	Common laboratory panel that may be ordered during the same visit for broader assessment when indicated.
`87804`	Infectious agent antigen detection by immunoassay, respiratory viruses (e.g., influenza)	Performed alongside or prior to FebriDx in some workflows to identify specific viral pathogens.
`87880`	Infectious agent detection by immunoassay, group A streptococcus	Often performed when suspicion for streptococcal pharyngitis coexists with respiratory symptoms.

CPT 0001U: PreciseType HEA Multiplex Erythrocyte Antigen Assay

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: Urine Metabolomic Polyp Risk Assay (PolypDX™)

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa™ (OVA1 Next Generation) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) Urine Gene Expression Risk Test

CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

CPT 0007U: ToxProtect Urine Drug Screen with DNA Authentication

CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

CPT 0008U: H. pylori Antibiotic Resistance Panel, Gene Sequence Analysis

CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

CPT 0011U: Cordant CORE™ Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcript Testing

Showing 1–10 of 536

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`00`	Default — no modifier	Use when no special billing modifier applies.
`26`	Professional component	Use when billing only the physician interpretation/professional component separate from the technical component.
`TC`	Technical component	Use when billing only the technical component (test performance/supplies) separate from the professional component.
`QX`	Ordering physician not supervising CLIA-waived testing personnel	Use when the test is performed by personnel under a qualified general supervision model and billing requires the modifier.
`QY`	Physician directing CLIA-waived testing personnel	Use when the physician or other qualified practitioner directs testing personnel under an approved model.
`QK`	Physician performs test personally (specific programmatic contexts)	Use when program rules require indicating the physician personally performed or supervised the test.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services	Use when those clinicians provided the service per payer rules and modifier is requested.
`52`	Reduced services	Use when the full test procedure could not be completed or only a partial procedure was performed.
`53`	Discontinued procedure	Use when testing was started but discontinued for patient safety or other valid reason.
`78`	Unplanned return to operating/procedure room	Generally not applicable but may be used if a procedural complication required return for additional testing related to an invasive procedure.
`22`	Increased procedural services	Use when documentation supports substantially greater effort or resources for the testing encounter.
`23`	Unusual anesthesia	Not typically applicable for point‑of‑care testing; included when unusual anesthesia was required during an associated procedure.
`62`	Two surgeons	Not typically applicable; used when two practitioners of the same specialty share responsibility for a procedure.
`QX`	Modifier appears above; duplicate entries should be avoided — use once as appropriate.	Use as above.

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine	Common providers performing point‑of‑care respiratory testing in ambulatory settings.
208D00000X	Emergency Medicine	Urgent care / emergency clinicians frequently use rapid diagnostics for acute respiratory infections.
207L00000X	Internal Medicine	Primary care internists performing in‑office point‑of‑care testing.
363L00000X	Nurse Practitioner	NPs often perform and document point‑of‑care tests in ambulatory clinics.
367A00000X	Physician Assistant	PAs commonly conduct testing and manage acute respiratory encounters.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J06.9`	Acute upper respiratory infection, unspecified	Common presentation where FebriDx may assist in distinguishing viral vs bacterial etiology.
`J02.9`	Acute pharyngitis, unspecified	Pharyngitis evaluation may include point‑of‑care tests to guide antibiotic decisions.
`J20.9`	Acute bronchitis, unspecified	FebriDx can inform likelihood of bacterial involvement in acute bronchitis.
`J18.9`	Pneumonia, unspecified organism	When pneumonia is suspected, FebriDx results may contribute to initial management decisions.
`R05`	Cough	Symptom code frequently present in encounters where rapid differentiation of infection type is desired.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0442U`	FebriDx® Bacterial/Non–Bacterial Point–of–Care Assay — fingerstick whole‑blood test for MxA and CRP	Index PLA code for the point‑of‑care assay used to differentiate bacterial from non‑bacterial respiratory infection.
`36415`	Collection of venous blood by venipuncture	Used if a venous specimen is collected for additional laboratory testing alongside the point‑of‑care fingerstick assay.
`80053`	Comprehensive metabolic panel	Common laboratory panel that may be ordered during the same visit for broader assessment when indicated.
`87804`	Infectious agent antigen detection by immunoassay, respiratory viruses (e.g., influenza)	Performed alongside or prior to FebriDx in some workflows to identify specific viral pathogens.
`87880`	Infectious agent detection by immunoassay, group A streptococcus	Often performed when suspicion for streptococcal pharyngitis coexists with respiratory symptoms.

CPT 0001U: PreciseType HEA Multiplex Erythrocyte Antigen Assay

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: Urine Metabolomic Polyp Risk Assay (PolypDX™)

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa™ (OVA1 Next Generation) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) Urine Gene Expression Risk Test

CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

CPT 0007U: ToxProtect Urine Drug Screen with DNA Authentication

CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

CPT 0008U: H. pylori Antibiotic Resistance Panel, Gene Sequence Analysis

CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

CPT 0011U: Cordant CORE™ Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcript Testing

Showing 1–10 of 536

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 0442U: FebriDx Bacterial/Non-Bacterial Point-of-Care Assay

Sign up for cpt 0442U policy alerts

Billing Code Overview

OpenPayer

CPT 0442U: FebriDx Bacterial/Non-Bacterial Point-of-Care Assay

Sign up for cpt 0442U policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 0442U: FebriDx Bacterial/Non-Bacterial Point-of-Care Assay

Sign up for cpt 0442U policy alerts

Billing Code Overview

CPT 0442U: FebriDx Bacterial/Non-Bacterial Point-of-Care Assay

Sign up for cpt 0442U policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT code 0442U represent?

Where is the FebriDx test (0442U) typically performed?

Which billing modifiers may be used with 0442U and when would they apply?

What other CPT codes are commonly associated with encounters that include 0442U?

What clinical presentations or diagnoses are appropriate contexts for using 0442U?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT code 0442U represent?

Where is the FebriDx test (0442U) typically performed?

Which billing modifiers may be used with 0442U and when would they apply?

What other CPT codes are commonly associated with encounters that include 0442U?

What clinical presentations or diagnoses are appropriate contexts for using 0442U?

References