Summary & Overview
CPT 0610U: LifeScale Gram Negative Antibiotic Susceptibility Test
CPT code 0610U designates a proprietary laboratory assay—the LifeScale Gram Negative Kit (LSGN) paired with the LifeScale AST system from Affinity Biosensors LLC—that delivers rapid antimicrobial susceptibility results from a positive blood culture using microfluidic sensor technology. The test reports organism susceptibility categories and a minimum inhibitory concentration (MIC) with interpretive comments, supporting timely antimicrobial selection for gram-negative bacteremia. Nationally, PLA codes like 0610U matter because they identify manufacturer-specific diagnostics that can affect laboratory procurement, payer coverage decisions, and hospital workflow for sepsis care.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose and laboratory setting for this assay, a summary of payer coverage considerations and benchmarks where available, and context on how the PLA designation shapes coding and billing practices. The publication also outlines potential policy and reimbursement implications tied to single-source diagnostic technologies and highlights points of interest for laboratory administrators, hospital billing teams, and policy analysts evaluating adoption and coverage of novel antimicrobial susceptibility tests.
Billing Code Overview
CPT code 0610U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to the LifeScale Gram Negative Kit (LSGN) used with the LifeScale AST system from Affinity Biosensors LLC. The test measures bacterial growth from a positive blood culture in the presence of different antibiotics using microfluidic sensor technology, reporting organism susceptibility categories and the minimum inhibitory concentration (MIC) value along with interpretive comments.
-
Service type: Microfluidic-based antimicrobial susceptibility testing from positive blood culture (proprietary laboratory diagnostic assay)
-
Typical site of service: Clinical laboratories and hospital laboratory settings where positive blood cultures are processed
Data not available in the input for modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A 62-year-old hospitalized patient with a central line develops fever and hypotension. Blood cultures drawn from the central line and peripheral vein flag positive for gram-negative rods on preliminary Gram stain. The microbiology laboratory receives the positive blood culture bottle and performs rapid organism identification and susceptibility testing using the LifeScale Gram Negative Kit (LSGN) with the LifeScale AST system (0610U). The workflow: the positive blood culture is loaded onto the LifeScale microfluidic AST platform, which measures bacterial growth in the presence of multiple antibiotics and reports categorical susceptibility (susceptible, intermediate, resistant), minimum inhibitory concentration (MIC) values, and interpretive comments. Results are transmitted to the ordering clinician and antimicrobial stewardship team to inform targeted therapy adjustments, source control decisions, and infection control measures. Typical sites of service include hospital inpatient laboratories and hospital outpatient reference laboratories that process positive blood cultures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional interpretation component, if applicable and separately billable (rare for PLA tests). |