CPT 0580U: Lyme IgG ImmunoBlot for 31 Recombinant Borrelia Proteins

CPT code 0580U designates a Proprietary Laboratory Analyses (PLA) test for the iDart™ Lyme IgG ImmunoBlot Kit from ID–FISH Technology Inc. The assay identifies IgG antibodies to 31 recombinant Borrelia burgdorferi proteins to support diagnosis of past or ongoing Lyme disease infection. As a PLA code, 0580U maps to a single manufacturer-specific test, which has implications for payer coverage, coding specificity, and claims adjudication nationally.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the test, the likely service setting, and what to expect in payer interactions. The publication outlines common billing modifiers and notes when data are not available in the source input.

This summary provides a national perspective useful to laboratory billing staff, practice managers, and policy analysts seeking clear identification of the test, its intended clinical use, and the payer landscape relevant to authorization and claims processing. It also points to where one would look for benchmarks, coverage policies, and coding guidance if further operational detail is required.

Billing Code Overview

CPT code 0580U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to the iDart™ Lyme IgG ImmunoBlot Kit from ID–FISH Technology Inc. The test detects IgG antibodies against 31 recombinant proteins of Borrelia burgdorferi, the bacterium that causes Lyme disease, and is used to help determine whether a patient has been infected.

Service Type: Specialty laboratory serologic test (proprietary Lyme disease antibody immunoblot).

Typical Site of Service: Clinical laboratory or reference laboratory setting, including independent diagnostic laboratories and hospital laboratories that perform specialty infectious disease serology.

Clinical Context

A 42-year-old outdoor worker presents to an infectious disease clinic with a 3-week history of intermittent fevers, migrating arthralgias, fatigue, and a history of a recent tick bite while hiking in a Lyme-endemic area. The clinician performs a focused history and physical exam, documents possible early disseminated Lyme disease, and orders serologic testing. The laboratory test ordered is the proprietary iDart™ Lyme IgG ImmunoBlot Kit (0580U) to detect IgG antibodies against 31 recombinant Borrelia burgdorferi proteins. Blood is drawn in the clinic or outpatient phlebotomy unit, labeled with the patient and test identifiers, and sent to the performing laboratory (the specific manufacturer/lab listed for this PLA code). The lab performs the ImmunoBlot assay, interprets band patterns to determine IgG reactivity, and issues a report indicating reactive, nonreactive, or indeterminate results with band-level detail. Results are returned to the ordering clinician, who integrates serology with clinical presentation and other testing (for example, acute vs. convalescent serology or PCR) to assess for Lyme infection and determine further management. Typical site of service includes outpatient clinics, physician offices, and reference laboratories that process PLA tests.

Coding Specifications

Modifier	Description	When to Use
`00`	Default/No modifier	Use when no special circumstance modifier applies to the service.

Taxonomy Code	Specialty	Notes
207Q00000X	Infectious Disease	Ordering and interpreting clinicians for complex Lyme presentations.
207K00000X	Family Medicine	Primary care providers who evaluate tick exposure and order Lyme serology.
207L00000X	Internal Medicine	Internal medicine physicians who manage subacute or systemic Lyme disease.
363LF0000X	Clinical Laboratory	Laboratories that perform the proprietary ImmunoBlot assay.
208000000X	Pediatrics	Pediatricians assessing suspected Lyme disease in children.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`A69.20`	Lyme disease, unspecified	Direct diagnosis code for Lyme disease; indicates testing with `0580U` is clinically relevant.
`A69.21`	Meningitis due to Lyme disease	Used when neurologic manifestations prompt Lyme IgG testing as part of diagnostic evaluation.
`A69.23`	Arthritis due to Lyme disease	Used when joint symptoms suggest Lyme arthritis and IgG testing helps confirm prior or ongoing infection.
`A69.29`	Other conditions associated with Lyme disease	Captures other Lyme-related presentations where serologic testing is indicated.
`R50.9`	Fever, unspecified	Nonspecific symptom that may lead to ordering Lyme serology in endemic areas.
`M25.50`	Pain in joint, unspecified	Musculoskeletal complaints that commonly trigger evaluation for Lyme disease via IgG immunoblots.
`Z20.828`	Contact with and (suspected) exposure to other bacterial communicable diseases	Used when documented tick exposure prompts diagnostic testing including `0580U`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Frequently performed prior to `0580U` to obtain the specimen for serologic testing.
`86318`	Immunoassay for infectious agent antibody, qualitative or semiquantitative; initially established	May be used for other Lyme serology screening assays (EIA/ELISA) often ordered before or alongside the ImmunoBlot.
`86850`	Infectious agent serology, confirmatory test (e.g., Western blot)	Represents confirmatory or supplemental immunoblot testing; `0580U` is a proprietary immunoblot and may serve a similar confirmatory role.
`80053`	Comprehensive metabolic panel	Commonly ordered in conjunction with infectious disease workup to assess baseline organ function prior to treatment decisions.
`87070`	Culture, bacterial, any source, for identification, other than blood	Occasionally ordered if alternative bacterial infections are in the differential diagnosis; not routine for Lyme but part of broader workups.

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Summary & Overview