CPT 0522U: Tissue Specific Markers for Early Diagnosis of Sjögren’s Disease

CPT code 0522U is a Proprietary Laboratory Analyses (PLA) billing code for a blood test — Tissue Specific Markers for Early Diagnosis of Sjögren’s Disease from KSL Diagnostics Inc. — that detects antibodies to carbonic anhydrase VI, parotid-specific protein, and salivary protein 1 (SP1) using chemiluminescence; service type: clinical laboratory diagnostic serology, typical site of service: outpatient laboratory or hospital laboratory draw and analysis.

Customize your policy alerts

Sign up for cpt 0522U policy alerts

Get alerted when payer policies referencing 0522U are released or updated.

Monitor payer policy activity

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

Explore openpayer tools

View all tools

CPT 0522U: Tissue Specific Markers for Early Diagnosis of Sjögren’s Disease

Customize your policy alerts

Sign up for cpt 0522U policy alerts

Get alerted when payer policies referencing 0522U are released or updated.

Monitor payer policy activity

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

Clinical & Coding Specifications

Clinical Context

A 42-year-old woman presents to a rheumatology clinic with a 6-month history of dry eyes, dry mouth, intermittent parotid gland swelling, and fatigue. Initial evaluation includes focused history, ocular surface testing (Schirmer test), and serologic testing for common Sjögren’s antibodies. The clinician orders the proprietary laboratory test 0522U (Tissue Specific Markers for Early Diagnosis of Sjögren’s Disease from KSL Diagnostics Inc.) to detect antibodies to carbonic anhydrase VI, parotid-specific protein, and salivary protein 1 (SP1) using chemiluminescence.

Specimen collection is a routine peripheral blood draw performed in the outpatient laboratory or clinic (typical site of service: outpatient laboratory or physician office). The specimen is sent to the performing laboratory; 0522U is reported by the performing lab when the proprietary assay yields results. Results are reviewed by the ordering rheumatologist or primary care clinician as part of the diagnostic workup for suspected Sjögren’s disease, integrated with clinical exam, ocular testing, standard autoimmune serologies, and imaging or biopsy if indicated.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86141`	Antinuclear antibodies (ANA) by fluorescent or equivalent technique	Common initial serologic test for autoimmune disease; often ordered concurrently to screen for autoimmunity when evaluating for Sjögren’s.
`86431`	Immunoassay for IgG, IgA, IgM antibodies; single-step method (e.g., ELISA)	Represents standard laboratory immunoassay methods used for autoantibody detection; relates as a conventional alternative or complementary testing methodology.
`87899`	Unlisted infectious disease test	Occasionally used for novel or unique laboratory tests when no specific PLA code exists; `0522U` supersedes the need for an unlisted code for this proprietary assay.
`83516`	Immunoassay for tumor markers, qualitative or semiquantitative; multiple-step method	Example of an automated immunoassay CPT; included as a commonly performed laboratory immunoassay code in workflows involving serologic testing.
`82542`	Assay of salivary components (not otherwise classified) — hypothetical illustrative laboratory chemistry tests	Performed in specialized centers evaluating salivary proteins and may be part of comprehensive salivary diagnostics when assessing Sjögren’s disease.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
33	Modifier 33 was created by the American Medical Association in response to the Affordable Care Act to identify services provided for preventive intent. It is appended to CPT/HCPCS codes that could be…	- Use modifier -33 when a CPT/HCPCS service that can be billed as either preventive or diagnostic/treatment is provided with preventive intent and aligns with USPSTF A or B recommendations or other…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
364S00000X	Clinical Nurse Specialist	A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses…
207VE0102X	Reproductive Endocrinology Physician	An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility.
2081P0301X	Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician	A Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical,…
261QM1100X	Military/U.S. Coast Guard Outpatient Clinic/Center	The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental serv…

Related ICD-10-CM Codes

28 rows

ICD-10-CM Code	Description
E86.0	Dehydration
F45.41	Pain disorder exclusively related to psychological factors
G47.00	Insomnia, unspecified
H04.123	Dry eye syndrome of bilateral lacrimal glands
H04.129	Dry eye syndrome of unspecified lacrimal gland
H91.90	Unspecified hearing loss, unspecified ear
J30.9	Allergic rhinitis, unspecified
J31.0	Chronic rhinitis
K05.6	Periodontal disease, unspecified
L29.9	Pruritus, unspecified

Showing 1–10 of 28

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

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

CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

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

CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

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

CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression 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 Gene Panel

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: 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 Transcripts

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

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`86141`	Antinuclear antibodies (ANA) by fluorescent or equivalent technique	Common initial serologic test for autoimmune disease; often ordered concurrently to screen for autoimmunity when evaluating for Sjögren’s.
`86431`	Immunoassay for IgG, IgA, IgM antibodies; single-step method (e.g., ELISA)	Represents standard laboratory immunoassay methods used for autoantibody detection; relates as a conventional alternative or complementary testing methodology.
`87899`	Unlisted infectious disease test	Occasionally used for novel or unique laboratory tests when no specific PLA code exists; `0522U` supersedes the need for an unlisted code for this proprietary assay.
`83516`	Immunoassay for tumor markers, qualitative or semiquantitative; multiple-step method	Example of an automated immunoassay CPT; included as a commonly performed laboratory immunoassay code in workflows involving serologic testing.
`82542`	Assay of salivary components (not otherwise classified) — hypothetical illustrative laboratory chemistry tests	Performed in specialized centers evaluating salivary proteins and may be part of comprehensive salivary diagnostics when assessing Sjögren’s disease.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
33	Modifier 33 was created by the American Medical Association in response to the Affordable Care Act to identify services provided for preventive intent. It is appended to CPT/HCPCS codes that could be…	- Use modifier -33 when a CPT/HCPCS service that can be billed as either preventive or diagnostic/treatment is provided with preventive intent and aligns with USPSTF A or B recommendations or other…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
364S00000X	Clinical Nurse Specialist	A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses…
207VE0102X	Reproductive Endocrinology Physician	An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility.
2081P0301X	Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician	A Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical,…
261QM1100X	Military/U.S. Coast Guard Outpatient Clinic/Center	The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental serv…

Related ICD-10-CM Codes

28 rows

ICD-10-CM Code	Description
E86.0	Dehydration
F45.41	Pain disorder exclusively related to psychological factors
G47.00	Insomnia, unspecified
H04.123	Dry eye syndrome of bilateral lacrimal glands
H04.129	Dry eye syndrome of unspecified lacrimal gland
H91.90	Unspecified hearing loss, unspecified ear
J30.9	Allergic rhinitis, unspecified
J31.0	Chronic rhinitis
K05.6	Periodontal disease, unspecified
L29.9	Pruritus, unspecified

Showing 1–10 of 28

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

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

CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

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

CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

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

CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression 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 Gene Panel

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: 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 Transcripts

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 0522U: Tissue Specific Markers for Early Diagnosis of Sjögren’s Disease

Sign up for cpt 0522U policy alerts

OpenPayer

CPT 0522U: Tissue Specific Markers for Early Diagnosis of Sjögren’s Disease

Sign up for cpt 0522U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

CPT 0522U: Tissue Specific Markers for Early Diagnosis of Sjögren’s Disease

Sign up for cpt 0522U policy alerts

CPT 0522U: Tissue Specific Markers for Early Diagnosis of Sjögren’s Disease

Sign up for cpt 0522U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What is CPT 0522U and what does this test detect?

Where and how is the specimen for 0522U collected and processed?

Which billing modifiers are listed for use with 0522U and what do they indicate?

What related CPT codes are listed and how do they relate to 0522U?

For which clinical indications or ICD‑10 diagnoses is 0522U presented as relevant?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What is CPT 0522U and what does this test detect?

Where and how is the specimen for 0522U collected and processed?

Which billing modifiers are listed for use with 0522U and what do they indicate?

What related CPT codes are listed and how do they relate to 0522U?

For which clinical indications or ICD‑10 diagnoses is 0522U presented as relevant?

References