CPT 0594U PSP Rapid Sepsis Test Reimbursement

CPT code 0594U designates a Proprietary Laboratory Analyses (PLA) test for the IVD CAPSULE PSP — Rapid Sepsis Test from Abionic SA. The assay measures pancreatic stone protein (PSP) in whole blood to estimate a patient’s risk of developing sepsis, offering potential for earlier risk stratification in acute care settings. Nationally, adoption of PLA codes like 0594U matters because they identify manufacturer- or lab-specific diagnostics that can influence clinical pathways, utilization patterns, and coverage determinations.

Key payers covered 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, typical sites of service, and the service type. The publication also summarizes payer coverage context, common billing modifiers used with PLA laboratory codes, and where 0594U fits alongside other laboratory diagnostics for sepsis risk assessment. This briefing provides benchmarks and policy-relevant insights to inform coding, billing, and payer discussions, and offers clinical context for how PSP measurement is used in early inflammation and sepsis risk estimation.

Data not available in the input: associated taxonomies, ICD-10 diagnoses, related codes, and service line details.

Billing Code Overview

CPT code 0594U is a Proprietary Laboratory Analyses (PLA) code for the IVD CAPSULE PSP — Rapid Sepsis Test from Abionic SA. The test analyzes a whole blood sample to measure levels of pancreatic stone protein (PSP), a biomarker associated with early inflammation, and reports an estimated risk that a patient will develop sepsis.

Service type: In vitro diagnostic laboratory test (proprietary/Pla)

Typical site of service: Clinical laboratory or hospital laboratory, performed on whole blood samples

Clinical Context

A typical patient is an adult presenting to the emergency department or an acute care observation unit with nonspecific signs of infection and early systemic inflammation—for example, fever, tachycardia, hypotension, altered mental status, shortness of breath, or unexplained leukocytosis. The clinician performs a focused assessment for possible sepsis and orders point-of-care or near-patient laboratory testing to risk-stratify the patient. A whole blood sample is obtained via venipuncture (or an existing intravenous catheter) and sent to the laboratory for the IVD CAPSULE PSP — Rapid Sepsis Test by Abionic SA, reported with CPT code 0594U. The test measures pancreatic stone protein (PSP) levels to help estimate the patient’s risk of developing sepsis.

Results are returned to the ordering clinician and incorporated with clinical exam, vital signs, and other laboratory tests (for example, complete blood count, lactate, and blood cultures) to guide monitoring intensity, decisions about admission versus discharge, escalation of care, or need for early empiric antibiotics. Typical sites of service include hospital emergency departments, inpatient acute care wards, observation units, and outpatient urgent care clinics equipped to collect and process whole blood for this proprietary laboratory analysis.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services

Taxonomy Code	Specialty	Notes
207Q00000X	Emergency Medicine	Emergency physicians commonly order sepsis risk stratification tests in ED settings.
207R00000X	Internal Medicine	Hospitalists and internists order and interpret results for inpatients.
208D00000X	Critical Care Medicine	Intensivists use PSP results to assess early risk of sepsis in critically ill patients.
207L00000X	Family Medicine	Primary care and urgent care clinicians may use the test in urgent care settings for risk assessment.
2080S00000X	Pathology/Laboratory Medicine	Laboratory medicine specialists oversee test validation, reporting, and quality control.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`R65.20`	Severe sepsis without septic shock	PSP levels assist in risk estimation for patients who may meet criteria for severe sepsis.
`R65.21`	Severe sepsis with septic shock	Elevated PSP can be part of early recognition among patients progressing toward septic shock.
`R65.10`	Systemic inflammatory response syndrome (SIRS) of non-infectious origin without acute organ dysfunction	PSP may rise with early systemic inflammation and help differentiate risk of infectious versus noninfectious causes.
`A41.9`	Sepsis, unspecified organism	PSP rapid testing contributes to early sepsis risk assessment before organism identification.
`R50.9`	Fever, unspecified	PSP measurement can be used when fever prompts evaluation for possible sepsis.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Specimen collection method commonly used to obtain whole blood for the PSP rapid test.
`81025`	Urinalysis, by dipstick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, specific gravity, etc.; automated	Performed alongside sepsis workup to assess possible urinary source of infection.
`80053`	Comprehensive metabolic panel (CMP)	Common concurrent laboratory panel to evaluate organ function and electrolyte disturbances in patients at risk for sepsis.
`80061`	Lipid panel	Not routine for sepsis evaluation but may be ordered in broader acute medical assessment; included here as sometimes performed during same encounter.
`85025`	Complete blood count (CBC) with automated differential	Frequently ordered with PSP testing to evaluate white blood cell count and differential in suspected infection.

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Summary & Overview

CPT 0594U: PSP Rapid Sepsis Test