Summary & Overview
CPT 0595U: Biofire Filmarray Tropical Fever Panel, Whole Blood RT–PCR
CPT code 0595U designates a proprietary laboratory analysis for the Biofire® Filmarray® Tropical Fever (TF) Panel, a multiplex RT–PCR test performed on whole blood to detect a range of viruses, bacteria, and parasites that cause tropical infections. As a PLA code, 0595U applies to a unique test offered by a specific manufacturer and is used to identify this single assay in billing and reporting.
This national-level summary examines payer coverage and clinical context for 0595U. Key payers reviewed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of where this test is typically performed, the clinical applications for diagnosing vector- and animal-borne tropical pathogens, and what the CPT designation signifies for laboratory billing.
The publication provides benchmarks and policy-relevant information about proprietary lab code usage, explains clinical indications and typical sites of service, and highlights where data are not available in the input. It is intended to inform laboratory administrators, billing professionals, and policy analysts about the scope and billing identity of this specific molecular diagnostic assay.
Billing Code Overview
CPT code 0595U is a Proprietary Laboratory Analyses (PLA) code for the Biofire® Filmarray® Tropical Fever (TF) Panel produced by bioMérieux. This test analyzes a sample of whole blood using real–time reverse transcription polymerase chain reaction (RT–PCR) to detect multiple pathogens that cause tropical diseases. Each result reports the presence or absence of specific viruses, bacteria, and parasites that may be transmitted by insects or animals.
Service type: Laboratory testing using multiplex RT–PCR for infectious disease detection.
Typical site of service: Clinical laboratory or hospital laboratory performing proprietary molecular diagnostic testing on whole blood samples.
Clinical & Coding Specifications
Clinical Context
A patient presents to an emergency department or inpatient unit after recent travel to a tropical region with acute febrile illness, headache, myalgias, and possible rash. The treating clinician suspects a vector‑borne or travel‑related infection (for example dengue, chikungunya, Zika, leptospirosis, malaria, or other tropical pathogens) and orders molecular testing to expedite pathogen identification. Whole blood is collected (phlebotomy) and sent to a certified clinical laboratory that performs the Biofire® FilmArray® Tropical Fever (TF) Panel. The lab performs real‑time RT‑PCR on the sample and reports presence/absence results for each panel target. Results inform infection control decisions, targeted antimicrobial or antiviral therapy, and public health reporting. Typical sites of service include hospital laboratories, reference laboratories, and hospital outpatient or emergency departments where rapid molecular diagnostics are available.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Standard professional/technical reporting (no modifier) | Use when submitting the PLA code for routine reporting without additional payment modifiers when payer requires explicit 00 indicator. |
22 | Increased procedural services | Use when work or resources substantially exceed usual for the single‑manufacturer test (rare for PLA; document justification).
52 | Reduced services | Use when the test is partially performed or limited in scope (for example, testing failed for some targets and partial results reported).
53 | Discontinued procedure | Use when the laboratory begun testing but discontinued prior to valid result (document reason).
59 | Distinct procedural service | Use if another unrelated laboratory procedure on same day must be distinctly identified (ensure clinical justification).
76 | Repeat procedure by same physician/lab | Use when the identical PLA test is repeated by the same performing laboratory for the same patient during the same encounter.
77 | Repeat procedure by another physician/lab | Use when the identical PLA test is repeated by a different performing laboratory for the same patient during the same encounter.
90 | Reference (outside) laboratory | Use when the performing lab bills but testing is performed by an outside reference laboratory under agreement.
91 | Repeat clinical diagnostic laboratory test | Use when a repeat test is performed on the same day and reporting both results is clinically necessary.
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207R00000X | Infectious Disease Specialist | Consultants who interpret results and guide therapy for tropical infections. |
208000000X | Pathology (Clinical Pathology) | Laboratory directors and clinical pathologists overseeing molecular diagnostic testing.
207L00000X | Preventive Medicine (Public Health) | Public health clinicians involved in reporting and outbreak management.
363LP0800X | Laboratory Technician/Technologist | Personnel performing molecular assays and reporting results.
171M00000X | Emergency Medicine | Ordering clinicians in ED where rapid diagnosis guides acute management.
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
A92.8 | Other mosquito-borne viral fevers | Represents suspected mosquito‑transmitted arboviral infections detected on tropical fever panels. |
A98.4 | O'nyong-nyong fever | Specific tropical viral infection that may be included among differential diagnoses when using the panel.
A99 | Other arthropod-borne viral fevers | Represents other arboviral etiologies targeted by broad molecular panels.
B25.9 | Cytomegalovirus disease, unspecified | Viral infections considered in differential; panel may help exclude specific viral pathogens.
A54.8 | Other gonococcal infections | Bacterial/zoonotic infections can present with systemic symptoms prompting broad testing.
B51.9 | Malaria, unspecified | Parasitic infections like malaria are key considerations in travel-related febrile illness and may be targeted or ruled out by specialized testing.
A87.9 | Viral meningitis, unspecified | Some tropical pathogens can present with neurologic involvement prompting use of multiplex molecular diagnostics.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36415 | Collection of venous blood by venipuncture | Blood specimen collection required prior to performing the Biofire® FilmArray® TF Panel. |
87880 | Infectious agent antigen detection by nucleic acid (e.g., PCR) | Related molecular diagnostic methodology codes; used for other PCR-based pathogen testing when PLA code not applicable.
87428 | Infectious agent detection by nucleic acid (e.g., influenza A/B) | Example of single‑organism molecular tests that may be ordered alongside or prior to a broad panel.
99000 | Handling and/or conveyance of specimen (when used) | Administrative/handling code occasionally used by facilities for courier/specimen transport related services.
81161 | Infectious disease molecular test (example: pathogen-specific sequencing) | Advanced molecular characterization that may follow panel detection for strain typing or resistance analysis.