Summary & Overview

CPT 0589U: PFAS Panel 2 — 24 PFAS Quantitative Test

CPT code 0589U designates a proprietary laboratory test — the PFAS Panel 2 measuring 24 PFAS compounds performed by Quest Diagnostics®. The assay uses LC–MS/MS to provide numeric concentrations of 24 common per- and polyfluoroalkyl substances in plasma or serum. This code matters nationally as PFAS exposure has public health, clinical monitoring, and environmental implications; standardized billing enables lab reporting, surveillance, and payer coverage discussions for advanced toxicology testing.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines which payers commonly encounter requests for PFAS testing and summarizes national coverage and billing considerations.

Readers will find benchmarks for utilization and reimbursement trends, policy and coverage update highlights affecting proprietary lab tests, and clinical context about when PFAS quantification is used (occupational exposure assessment, environmental exposure follow-up, and research settings). The report also explains service setting expectations, coding specifics for reporting this single-manufacturer PLA test, and notes where input data is not available. Data not available in the input.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0589UCPTProprietary Laboratory AnalysesPFASLC-MS/MSToxicologyLaboratorySerumPlasma

Billing Code Overview

CPT code 0589U is a Proprietary Laboratory Analyses (PLA) code that applies to a single, manufacturer-specific laboratory test: PFAS Panel 2 – 24 PFAS from Quest Diagnostics®. The assay uses LC–MS/MS to quantify 24 common per- and polyfluoroalkyl substances (PFAS) in plasma or serum, reporting numeric concentrations for each compound. This test measures persistent synthetic chemicals often referred to as “forever chemicals.”

Service type: Laboratory test — quantitative toxicology panel

Typical site of service: Clinical laboratory or hospital outpatient laboratory

Clinical & Coding Specifications

Clinical Context

A middle-aged adult presents to an occupational or environmental medicine clinic after living near an industrial site with known PFAS contamination and requests testing for systemic exposure. The clinician documents potential exposure history (drinking water contamination, occupational contact, or prior firefighting foam exposure) and orders 0589U (PFAS Panel 2 – 24 PFAS, plasma/serum) to quantify individual PFAS concentrations using LC–MS/MS. Blood is drawn in an outpatient laboratory or hospital phlebotomy station; plasma or serum is prepared per the laboratory's specimen requirements and sent to Quest Diagnostics® or the proprietary testing lab. Results provide numeric concentrations for each PFAS compound; the clinician reviews results with the patient, integrates findings with exposure history and clinical assessment, and documents interpretation and any recommended follow-up monitoring or environmental mitigation steps in the medical record.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (standard)	Use for routine reporting of `0589U` when no special circumstances apply.
`22`	Increased procedural services	Use when reporting additional complexity in specimen handling or reporting beyond typical lab processes if payer accepts modifier for lab services.
`52`	Reduced services	Use when the lab performed a subset of the full panel or a limited analysis compared to standard `0589U` panel.
`53`	Discontinued procedure	Use if specimen collection was initiated but testing was aborted prior to analysis and reporting.
`59`	Distinct procedural service	Use when another unrelated lab procedure is billed the same day and it is appropriate to indicate distinct service (payer-specific acceptance varies).
`76`	Repeat procedure by same provider	Use when `0589U` is repeated on the same patient by the same provider during a defined monitoring interval.
`77`	Repeat procedure by another provider	Use when a different provider orders a repeat `0589U` within a monitored timeframe.
`90`	Reference (outside) laboratory	Use when the performing lab is an outside/reference laboratory and billing or reporting requires this modifier.
`91`	Repeat clinical diagnostic lab test	Use when the exact same PFAS panel is repeated on the same specimen type to verify results (some payers require this for confirmatory testing).
`99`	Multiple modifiers may apply	Use per payer guidance when more than one modifier needs to be reported (if permitted).

Taxonomy Code	Specialty	Notes
208D00000X	Diagnostic Laboratory	Clinical laboratories performing LC–MS/MS PFAS quantification.
208000000X	Pathology & Laboratory Medicine	Pathologists or laboratory medicine specialists overseeing assay validation and interpretation.
207R00000X	Occupational Medicine	Occupational medicine physicians ordering PFAS testing for exposure assessment.
207L00000X	Preventive Medicine	Preventive medicine specialists managing environmental exposure screening and follow-up.
2084P0800X	Toxicology	Clinical toxicologists involved in interpretation of PFAS toxicology and patient counseling.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z77.22`	Contact with and (suspected) exposure to per- and polyfluoroalkyl substances (PFAS)	Directly indicates documented exposure history motivating `0589U` testing.
`Z13.838`	Encounter for screening for other metabolic, endocrine, nutritional and blood disorders	Used when PFAS testing is part of broader environmental or metabolic screening.
`T59.9X5A`	Toxic effect of other gases, fumes and vapors, accidental, initial encounter	May be used when acute or accidental high-level exposure to chemical agents including PFAS-containing substances is documented.
`Z71.82`	Counseling for environmental exposure (counseling related to possible environmental hazard)	Used when counseling accompanies PFAS testing and exposure management.
`R68.89`	Other general symptoms and signs	Used when nonspecific symptoms possibly related to PFAS exposure (fatigue, malaise) prompt testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81002`	Urinalysis, by dipstick or tablet reagent; non-automated, without microscopy	May be performed in the clinic visit for general screening or to assess renal function prior to PFAS testing, though not directly related to PFAS quantification.
`80053`	Comprehensive metabolic panel (CMP)	Commonly ordered alongside PFAS testing to assess liver and kidney function, which can be relevant for interpretation of PFAS burden and clinical management.
`82565`	Drug assay, qualitative; multiple drug classes (e.g., mass spectrometry), unless otherwise specified	Represents other mass spectrometry-based assays performed in the same lab; indicates parallel use of LC–MS/MS platforms though not specific to PFAS.
`36415`	Collection of venous blood by venipuncture	Performed immediately prior to `0589U` specimen submission for plasma or serum collection.
`99000`	Handling and/or conveyance of specimen for transfer from physician's office to a lab	Applicable when additional specimen handling or courier services are billed for transport of the PFAS sample to the reference laboratory.