Summary & Overview
CPT 0455U: Abbott Alinity m Multiplex STI Assay
CPT code 0455U designates a Proprietary Laboratory Analyses (PLA) test for the Abbott Alinity™ m STI Assay, a multiplex nucleic acid amplification test for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. As a PLA code, 0455U is specific to a single manufacturer's assay and is used to identify this unique laboratory service in claims and reporting. Nationally, precise PLA coding supports tracking of test utilization, payer coverage decisions, and alignment of laboratory reporting with public health surveillance for common sexually transmitted infections.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for multiplex STI testing, typical sites of service where the assay is performed, and the implications of PLA coding for billing workflows. The publication summarizes payer coverage landscape, common modifiers encountered in claims for laboratory services, and operational considerations for reporting a manufacturer-specific assay. Data not available in the input is noted as such where applicable.
Billing Code Overview
CPT code 0455U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to the Abbott Alinity™ m STI Assay from Abbott Molecular Inc. The test uses a multiplex amplified probe technique to detect Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in clinical specimens.
Service type: Molecular diagnostic assay for sexually transmitted infections (multiplex nucleic acid amplification test)
Typical site of service: Clinical laboratories and outpatient specimen collection sites. The assay is reported when testing vaginal swabs, endocervical swabs, gynecological specimens, oropharyngeal swabs, rectal swabs, female urine, or male urine.
Clinical & Coding Specifications
Clinical Context
A sexually active adult or adolescent presents to an outpatient clinic, urgent care, sexual health clinic, or emergency department with genitourinary or sexual exposure concerns such as vaginal discharge, dysuria, pelvic pain, urethral discharge, rectal pain, or recent condomless oral/anal sex. The clinician performs a focused sexual health history and physical exam and collects specimens appropriate to exposure and symptoms: vaginal or endocervical swab for people with a cervix, oropharyngeal swab for oral exposure, rectal swab for receptive anal exposure, and/or first-catch urine for people without cervical sampling. The specimen(s) are sent to the performing laboratory using standard transport and chain-of-custody procedures for nucleic acid amplification testing (NAAT). The laboratory runs the Abbott Alinity™ m STI Assay — reported with CPT code 0455U — which multiplexes amplified probes to detect Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Results are reported back to the ordering clinician, who documents results, notifies the patient, and proceeds with treatment, partner notification, or further testing as indicated. Typical sites of service include outpatient clinics, community sexual health centers, urgent care centers, and hospital laboratories; the service type is laboratory diagnostic testing (Proprietary Laboratory Analyses).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default — No modifier | Use when no modifier applies to the lab service |
26 | Professional Component | Use when reporting only the laboratory’s professional interpretation component if applicable to a split technical/professional billing arrangement
52 | Reduced Services | Use when the laboratory performs a reduced or limited version of the described test (rare for PLA tests)
53 | Discontinued Procedure | Use if testing was started but discontinued prior to completion for documented medical reasons
62 | Two Surgeons | Generally not applicable to lab testing; include only if billing rules require for associated surgical services
78 | Return to Operating Room | Not typically used for lab testing; included only when tied to a related surgical global period return
80 | Assistant Surgeon | Not applicable to laboratory procedures; use only for associated surgical care
QX | CLIA Waiver Exemption (Typical/Direct) | Use when a qualified laboratory practitioner performed the test under applicable billing rules (modifier use varies by payer)
QY | Paired Specimen Testing | Use when specimen handling requires paired testing or confirmatory workflow that payers recognize
TC | Technical Component | Use when billing only the technical component of the laboratory assay (instrumentation, reagents, processing) separate from professional interpretation
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207Q00000X | Infectious Disease | Specialists ordering confirmatory or epidemiologic STI testing |
363L00000X | Clinical Laboratory | Performing laboratory directors and diagnostic laboratory services
208D00000X | Obstetrics & Gynecology | Common ordering specialty for screening and symptomatic testing in patients with cervices
208U00000X | Family Medicine | Primary care orders for screening and symptomatic STI evaluation
128W00000X | Emergency Medicine | Orders from urgent care and ED settings where symptomatic patients present
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
A74.9 | Unspecified chlamydial infection | Chlamydia is a target organism of the 0455U assay and is commonly tested in symptomatic or screening patients |
A54.9 | Gonococcal infection, unspecified | Gonorrhea is detected by the assay and is a frequent indication for NAAT testing
A59.9 | Trichomoniasis, unspecified | Trichomonas vaginalis is included in the multiplex panel and is tested in symptomatic and screening contexts
R82.99 | Other abnormal findings in specimens from other organs and systems | May accompany abnormal urine or genital specimen results prompting molecular testing
Z11.3 | Encounter for screening for infections with a predominantly sexual mode of transmission | Common screening indication for ordering multiplex STI NAAT such as 0455U
R68.83 | Chills (as an example of constitutional symptom) | Non-specific symptoms that may accompany systemic infection and prompt STI testing
N39.0 | Urinary tract infection, site not specified | Urogenital symptoms prompting urine NAAT may be used to distinguish STI from urinary tract infection
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
87491 | Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique, direct probe technique, single target | Historically used for single-target Chlamydia testing; may be ordered if multiplex testing unavailable or for confirmatory single-organism testing |
87591 | Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique, direct probe technique, single target | Single-organism gonorrhea NAAT used when multiplex NAAT not performed or for follow-up
87798 | Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms (e.g., multiplex panels) | Related multiplex testing codes; used for broader panels that may include other organisms beyond CT/GC/TV when different platform or non-proprietary tests are performed
86580 | Skin test; tuberculosis, intradermal | Often performed in parallel in sexual health evaluations for high-risk populations or when additional screening is indicated
87660 | Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique | Single-organism NAAT for Trichomonas when ordered separately from multiplex testing