Summary & Overview
CPT 0527U: Abbott Alinity m HSV 1 & 2 and VZV Molecular Assay
CPT code 0527U identifies a proprietary molecular diagnostic assay—the Abbott Alinity™ m HSV 1 & 2 / VZV Assay—that detects HSV-1, HSV-2 and varicella zoster virus (VZV) in clinical specimens. As a PLA code, 0527U represents a single manufacturer's test and is used when reporting that specific assay. Nationally, proprietary molecular assays like this are important for rapid, pathogen-specific diagnosis that can guide infection control and antiviral management.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. The publication provides benchmarks and context for coverage and reimbursement for proprietary laboratory analyses, summarizes clinical indications and testing workflow, and highlights implications for laboratory service lines that perform high-complexity molecular testing. Readers will find a concise description of the test and service setting, comparison points for payer coverage considerations, and clinical context on when HSV and VZV molecular testing is used. Data not available in the input is identified where applicable.
Billing Code Overview
CPT code 0527U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to the Abbott Alinity™ m HSV 1 & 2 / VZV Assay from Abbott Molecular Inc. The assay uses an amplified probe technique to detect herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), and varicella zoster virus (VZV) in clinical specimens, with results reported for each pathogen as detected or not detected.
Service type: Molecular diagnostic infectious disease testing (proprietary laboratory assay)
Typical site of service: Clinical laboratory or hospital laboratory performing molecular diagnostics
Clinical & Coding Specifications
Clinical Context
A 28-year-old immunocompetent adult presents to an urgent care clinic with a painful vesicular rash on the lip and oral mucosa and reports fever and prodromal tingling. The clinician obtains a swab of the lesion and orders the Abbott Alinity™ m HSV 1 & 2 / VZV Assay to identify herpes simplex virus type 1, herpes simplex virus type 2, or varicella zoster virus to guide infection control and antiviral selection. The specimen is transported to the laboratory where a molecular technologist performs the proprietary amplified probe assay. Results are reported as each pathogen “detected” or “not detected.” Typical sites of service include hospital outpatient laboratory, independent clinical laboratory, reference laboratory, and urgent care or ambulatory clinic collecting and sending specimens. The service type is a laboratory molecular diagnostic test (Proprietary Laboratory Analyses, PLA). Common clinical workflow steps: clinician evaluation and specimen collection; specimen accessioning and testing on the Abbott Alinity™ m platform; documentation of results in the laboratory information system; transmission of results to the ordering provider; and clinical interpretation and management by the ordering clinician.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no special modifier applies and the full service is billed |
26 |