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 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

Taxonomy Code	Specialty	Notes
`103K00000X`	Reproductive Endocrinology and Infertility (REI)	Physicians directing IVF cycles and embryo transfer decisions.
`331K00000X`	Clinical Laboratory	Laboratories performing molecular genetic testing and reporting results.
`207K00000X`	Obstetrics & Gynecology	Gynecologists involved in IVF care and patient counseling.
`362M00000X`	Molecular Pathology	Specialists interpreting genomic assay results and quality control.
`207L00000X`	Gynecologic Oncology (when applicable)	Rarely involved when genetic counseling overlaps with oncologic risk assessments.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N97.0`	Female infertility associated with anovulation	Common indication for IVF and therefore potential candidate for PGT using `0555U`.
`N97.1`	Female infertility of tubal origin	Patients undergoing IVF for tubal factor infertility may elect PGT to optimize embryo selection.
`N97.9`	Female infertility, unspecified	General infertility diagnoses leading to IVF and consideration of preimplantation genetic testing.
`O26.89`	Other specified pregnancy-related conditions	Relevant for patients with complex reproductive histories where genetic testing may be considered.
`Z31.84`	Encounter for assisted reproductive fertility procedure cycle, embryo transfer	Clinical context for embryos created and evaluated with `0555U` prior to transfer.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0030U`	Preimplantation genetic testing for aneuploidy and structural rearrangements (example PLA) — technical description varies by manufacturer	Another PLA for PGT; may be an alternate proprietary assay used for embryo chromosome analysis in the IVF workflow.
`88381`	Microdissection procedures including specimen procurement for cytogenetic or molecular assay	Billing for trophectoderm biopsy procurement when separately reportable by the facility or pathology service.
`81479`	Unlisted molecular pathology procedure	Use when a molecular test performed does not have a specific CPT and no PLA code applies; rarely used for adjunct or supplementary testing.
`89250`	Embryo biopsy, blastocyst stage (trophectoderm)	Procedure code for performing the biopsy on blastocysts prior to sending specimen for `0555U` testing.
`89260`	Cryopreservation; embryo(s) — storage and related services	Often performed when embryos are biopsied and results will guide later frozen embryo transfer.

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Summary & Overview