Summary & Overview
CPT 0483U: Ciprofloxacin Susceptibility Test for Neisseria gonorrhoeae
CPT code 0483U is a Proprietary Laboratory Analyses (PLA) code for a molecular test that identifies a mutation in Neisseria gonorrhoeae conferring resistance to ciprofloxacin. As a PLA code, it applies to a single specific commercial test offered by MedArbor Diagnostics and SpeeDx Inc., and is used when oral, rectal, or vaginal swab specimens are analyzed to determine ciprofloxacin susceptibility. This code matters nationally as antimicrobial resistance in Neisseria gonorrhoeae is a public health concern and targeted susceptibility testing can inform treatment selection and stewardship efforts.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the test, typical service setting, and the payer landscape considered. The publication provides benchmarks where available, notes on coverage patterns, and clinical context about specimen types and the molecular target of the assay. Data not available in the input is noted where applicable. The content is intended for clinicians, coding and billing professionals, and policy analysts seeking a clear national summary of CPT code 0483U and its role in diagnostic testing for ciprofloxacin resistance in gonococcal infections.
Billing Code Overview
CPT code 0483U is a Proprietary Laboratory Analyses (PLA) code for Ciprofloxacin Susceptibility of Neisseria gonorrhoeae performed by MedArbor Diagnostics and SpeeDx Inc. The test detects a specific mutation in Neisseria gonorrhoeae that indicates resistance to the antibiotic ciprofloxacin.
Service type: Diagnostic molecular susceptibility testing
Typical site of service: Clinical laboratory or reference laboratory
Clinical & Coding Specifications
Clinical Context
A 27-year-old sexually active patient presents to a sexual health clinic with symptoms of urethral discharge and dysuria after unprotected intercourse. A clinician collects an oral, rectal, and vaginal swab based on reported exposure sites and clinical exam. Rapid molecular testing for Neisseria gonorrhoeae is positive, and the clinician orders a targeted proprietary assay to determine ciprofloxacin susceptibility by detecting a specific resistance-associated mutation in N. gonorrhoeae. The specimen is sent to MedArbor Diagnostics / SpeeDx Inc. for the proprietary test reported by 0483U. Results guide epidemiologic surveillance and, where permitted by local treatment guidance, targeted antibiotic selection when ciprofloxacin susceptibility is confirmed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default billing indicator (no modifier) | Use when no other modifier applies and the service is furnished as usual. |
22 | Increased procedural services | Use when work required is substantially greater than typically required for this test (document justification).
52 | Reduced services | Use when the test is partially reduced or not fully performed (document reason).
53 | Discontinued procedure | Use when testing was started but discontinued due to circumstances that threatened patient safety or specimen integrity.
59 | Distinct procedural service | Use when this laboratory test is distinct and independent from other services performed on the same day (use sparingly for labs).
90 | Reference (outside) laboratory | Use when the specimen is sent to an outside laboratory for this proprietary test.
91 | Repeat clinical diagnostic laboratory test | Use when the same test is repeated on the same day to confirm results.
91 is often used for repeat molecular tests to confirm unexpected or indeterminate findings.
26 | Professional component | Use if billing only for the professional interpretation of the test by a qualified provider.
TC | Technical component | Use if billing only for the technical component (laboratory processing) of the test.
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RG0100X | Infectious Disease | Specialists may order targeted susceptibility testing for complex cases or treatment failures. |
207L00000X | Pathology & Laboratory Medicine | Laboratory directors and clinical pathologists oversee testing and result validation.
207V00000X | Public Health & General Preventive Medicine | Public health clinicians use results for surveillance and outbreak management.
208000000X | Obstetrics & Gynecology | OB/GYN clinicians commonly collect vaginal specimens and manage treatment of gonorrhea in patients assigned female at birth.
2080P0208X | Family Medicine | Primary care and sexual health clinicians frequently collect specimens and order NAAT and susceptibility testing.
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
A54.01 | Gonococcal infection of lower genitourinary tract, female | Primary diagnosis for symptomatic female patients undergoing gonorrhea testing and susceptibility assessment. |
A54.02 | Gonococcal infection of lower genitourinary tract, male | Primary diagnosis for symptomatic male patients where susceptibility testing may be ordered.
A54.03 | Gonococcal infection of pharynx | Relevant when an oral swab is tested for ciprofloxacin resistance-associated mutation.
A54.04 | Gonococcal infection of rectum | Relevant when a rectal swab is tested for ciprofloxacin resistance-associated mutation in patients with receptive anal exposure.
A64 | Unspecified sexually transmitted infection (not HIV) | Used when STI is suspected but specific organism not yet confirmed; triggers diagnostic testing including 0483U once gonorrhea is identified.
Z11.3 | Encounter for screening for infections with a predominantly sexual mode of transmission | Relevant for asymptomatic screening where positive NAAT may prompt reflex susceptibility testing using 0483U.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
87471 | Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique | Commonly used initial NAAT to detect N. gonorrhoeae before ordering targeted susceptibility testing with 0483U. |
87270 | Culture, bacterial, any other source except urine, pathogenic organisms identification | Used when culture is performed to obtain isolates for phenotypic susceptibility testing or confirmatory testing.
87651 | Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis | Often performed concurrently with gonorrhea NAAT as part of STI screening and specimen collection.
99000 | Handling and/or conveyance of specimen for transfer to another laboratory | May be used when specimens are transported to an outside reference lab such as MedArbor Diagnostics / SpeeDx Inc. for 0483U testing.
G0471 | Specimen collection for human papillomavirus testing, cervical or vaginal | When combined pelvic/sexually transmitted infection specimen collection is performed, related specimen collection codes may apply.