Summary & Overview
CPT 0555U: Preimplantation Genetic Testing for Structural Rearrangements
CPT code 0555U denotes a Proprietary Laboratory Analyses (PLA) test — Smart PGT–SR Plus — used in preimplantation genetic testing to screen IVF embryos for structural chromosome rearrangements and aneuploidy across all 24 chromosomes. The code is significant nationally because it identifies a manufacturer- or lab-specific assay that provides comprehensive genetic and quality-control information, including a mitochondrial DNA score, which can influence embryo selection in assisted reproduction.
Key payers in the coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for use in IVF programs, the service and typical site of service for this laboratory-based genetic analysis, and which major payers are commonly considered in coverage discussions. The publication outlines common billing modifiers associated with laboratory services and notes where input data are not available.
This summary equips clinicians, billing professionals, and policy analysts with an understanding of what 0555U represents, why PLA designation matters for billing and contracting, and what to expect when reconciling test reporting and claims across major national payers. Data not available in the input is explicitly marked where applicable.
Billing Code Overview
CPT code 0555U is a Proprietary Laboratory Analyses (PLA) code reported specifically for the Smart PGT–SR Plus test from Igenomix®, part of Vitrolife Group™, and Thermo Fisher Scientific. The test evaluates all 24 chromosomes in in vitro fertilization (IVF) embryos to detect structural rearrangements and numeric abnormalities using DNA sampled from the trophectoderm layer of the embryo. The service includes a mitochondrial DNA score and quality control results to identify potential testing issues.
Service type: Proprietary laboratory genetic analysis for preimplantation genetic testing (PGT-SR)
Typical site of service: Reference laboratory or specialized reproductive genetics laboratory supporting IVF clinics
Clinical & Coding Specifications
Clinical Context
A typical patient is a patient or couple undergoing in vitro fertilization (IVF) who elects preimplantation genetic testing for structural rearrangements and aneuploidy using the proprietary Smart PGT–SR Plus assay (0555U). The clinical workflow begins with ovarian stimulation, oocyte retrieval, fertilization and embryo culture to the blastocyst stage. A trophectoderm biopsy is performed on suitable blastocysts and the biopsy specimen is sent to the laboratory performing the 0555U test (Smart PGT–SR Plus from Igenomix®/Vitrolife Group™/Thermo Fisher Scientific). The laboratory performs DNA amplification and comprehensive chromosomal analysis across 24 chromosomes to detect aneuploidy and structural chromosome changes, generates a mitochondrial DNA (mtDNA) score and quality control metrics, and returns results to the fertility clinic. Results guide embryo selection for fresh or frozen embryo transfer. Typical site of service is an ambulatory fertility clinic, IVF center, or specialized embryology laboratory. Common clinical reasons include recurrent pregnancy loss, known parental balanced chromosomal rearrangement, advanced maternal age, prior IVF failures, or desire to reduce risk of chromosomal abnormalities prior to transfer.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting |