Summary & Overview
CPT 0542U: Kidney Transplant Monitoring with Urine Metabolites and BK PCR
CPT code 0542U designates a Proprietary Laboratory Analyses (PLA) test — myOLARIS™–KTdx from Olaris® Inc. — designed to monitor kidney transplant health. The test combines targeted urine metabolomics (84 analytes), BK virus detection by real‑time PCR, and a serum creatinine measurement to produce a probability score estimating the likelihood of transplant injury. As a PLA code, 0542U applies only to this specific commercial test and is intended for use by clinical and reference laboratories that perform the assay.
Nationally, tests that noninvasively monitor transplant status are increasingly important for reducing biopsy use and guiding patient management. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code’s clinical purpose, typical service setting, and payer landscape. The publication summarizes benchmarking and coverage context, highlights policy and coding considerations for PLA tests, and provides clinical context on how combined metabolite profiling with viral PCR and serum creatinine yields a probabilistic assessment of transplant injury risk. Data not available in the input for specific payer policies, reimbursement amounts, taxonomies, ICD‑10 diagnoses, and related codes are noted where relevant.
Billing Code Overview
CPT code 0542U is a Proprietary Laboratory Analyses (PLA) code for the myOLARIS™–KTdx test from Olaris® Inc. The assay analyzes urine for 84 metabolic analytes, integrates patient data, performs real‑time PCR testing for BK virus, and incorporates a serum creatinine measurement to produce a probability score estimating the likelihood of kidney transplant injury.
Service type: Proprietary multi‑analyte urine and molecular diagnostic test for kidney transplant monitoring
Typical site of service: Clinical laboratory (urine collection and laboratory processing with PCR and serum testing performed in a reference lab)
Clinical & Coding Specifications
Clinical Context
A 52-year-old kidney transplant recipient attends a routine post-transplant clinic visit 6 months after transplantation. The patient reports stable symptoms but has a recent low-grade serum creatinine rise on basic labs and intermittent low-level hematuria. The transplant nephrologist orders the myOLARIS™–KTdx test (0542U) to noninvasively assess for allograft injury. The clinic nurse provides a urine collection kit and draws a serum specimen for creatinine and orders real-time PCR testing for BK virus per the test bundle. The urine sample is shipped to the performing laboratory (Olaris® Inc.) under temperature-controlled conditions. Results return as a probabilistic score integrating urinary metabolite profiles (84 metabolites), BK PCR result, and serum creatinine, reported to the nephrology team. The result is used alongside clinical assessment, imaging, and other labs to inform surveillance decisions, such as adjusting immunosuppression, scheduling biopsy, or continued monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased Procedural Services | Use when the laboratory or associated professional documents a significantly increased complexity in processing or reporting beyond usual test operations (e.g., additional interpretive effort, extensive consultation). |