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    v1.0.28
    OpenPayerBilling CodesOtherHCPCS hcpcs-u0004-sars-cov-2-high-throughput-molecular-test-multiplex
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    HCPCS U0004: COVID-19 Multiplex Molecular Test, High-Throughput Non-CDC

    HCPCS Level II code U0004 represents laboratory testing for SARS-CoV-2 (2019-nCoV/COVID-19) using high-throughput technologies that detect multiple viral targets or subtypes and are performed by non-CDC laboratories; the service is a molecular diagnostic multiplex test (any technique, multiple types or subtypes, includes all targets) typically provided in clinical laboratory or high-complexity testing laboratory settings and billed as a COVID-19 molecular diagnostic assay.

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    Table of contents

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    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
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    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
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    Clinical & Coding Specifications

    Clinical Context

    A symptomatic adult presents to a high-throughput clinical laboratory or hospital outpatient testing site with fever, cough, and recent exposure to a confirmed SARS-CoV-2 case. A nasopharyngeal or anterior nasal swab is collected using facility protocols. The specimen is received in a certified molecular laboratory that runs non-CDC high-throughput SARS-CoV-2 assays capable of detecting multiple viral targets or subtypes. The laboratory performs automated extraction and amplification on high-throughput platforms and reports a qualitative positive or negative result. Typical workflow steps include specimen accessioning, barcode scanning, nucleic acid extraction, amplification and detection using the laboratory’s validated assay, result verification by a molecular technologist, and electronic reporting to the ordering clinician and public health authorities as required. Billing is submitted under U0004 for specimens processed using these non-CDC high-throughput methods. Common settings include hospital laboratories, independent reference labs, and large outpatient collection centers equipped for batch molecular testing.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    87635Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), amplified probe techniqueCommonly used alternative CPT for SARS-CoV-2 molecular testing when reporting per specimen for single-target assays; may appear on claims alongside or instead of HCPCS depending on payer rules
    87636Infectious agent detection by nucleic acid (DNA or RNA); multiple organisms (multiplex), respiratory panelPerformed when multiplex respiratory pathogen panels including SARS-CoV-2 are ordered; workflow may include reflex to U0004 high-throughput methods for batch processing
    0003USevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant sequencing, multiplexed, whole genome or targeted, high throughputUsed when sequencing is performed following a positive U0004 result for variant surveillance; represents downstream specialized testing
    99000Handling and/or conveyance of specimen for transport to a laboratoryUsed by some facilities to bill specimen handling/transport steps in complex workflows involving off-site high-throughput labs
    99001Handling and/or conveyance of specimen for transport to a laboratory, rural or other specific circumstancesUsed in select circumstances for specimen logistics when permitted by payer policies

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    74Modifier ‑74 indicates an outpatient hospital or ASC procedure that was discontinued after anesthesia was administered and after the procedure had begun. Use this modifier when anesthesia (local,…- Use modifier -74 when a procedure in an outpatient hospital or ASC setting is terminated after anesthesia has been administered and after the procedure has commenced (for example, after incision,…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    163W00000XRegistered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    246XC2901XCardiovascular Invasive Specialist/TechnologistA cardiovascular invasive specialist/technologist monitors patients’ heart rates and helps physicians in diagnosing and treating heart problems. They …
    261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities · Clinic/Center
    1835X0200XOncology PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in developing, recommending, implementing, monitoring, and modifying pharma…
    207ZD0900XDermatopathology (Pathology) PhysicianA dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic di…

    Related Codes

    HCPCS-C1300-HYPERBARIC-OXYGEN-FULL-BODY-CHAMBER-30MIN

    HCPCS Level II C1300: Hyperbaric Oxygen, Full‑Body Chamber, per 30 min

    HCPCS-K0901-KNEE-ORTHOSIS-SINGLE-UPRIGHT-PREFABRICATED

    HCPCS Level II K0901: Knee Orthosis, Single Upright, Prefabricated

    HCPCS-K0902-KNEE-ORTHOSIS-DOUBLE-UPRIGHT-PREFABRICATED-OTS

    HCPCS Level II K0902: Knee Orthosis, Double Upright, Prefabricated

    HCPCS-K0903-DIABETIC-CUSTOM-MULTIPLE-DENSITY-INSERT

    HCPCS K0903: Diabetic Custom Multi-density Total Contact Insert

    HCPCS-K1001-ELECTRONIC-POSITIONAL-OSA-TREATMENT-SENSOR

    HCPCS K1001: Electronic Positional Obstructive Sleep Apnea Treatment

    HCPCS-K1002-CRANIAL-ELECTROTHERAPY-STIMULATION-SYSTEM

    HCPCS K1002: Cranial Electrotherapy Stimulation System

    HCPCS-K1003-WHIRLPOOL-TUB-WALK-IN-PORTABLE

    HCPCS Level II K1003: Whirlpool Tub, Walk-In, Portable

    HCPCS-LEVEL-II-M1144-LIMITED-CONSULTATIVE-THERAPY-1-2-VISITS

    HCPCS Level II M1144: Ongoing Care Not Indicated, 1–2 Visits

    HCPCS-M0064-PSYCHIATRIC-MEDICATION-MANAGEMENT-BRIEF-OFFICE-VISIT

    HCPCS M0064: Brief Visit for Psychiatric Medication Monitoring

    HCPCS-M1000-PAIN-SCREEN-MODERATE-SEVERE

    HCPCS M1000: Pain Screened as Moderate to Severe

    Showing 1–10 of 16

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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