CPT code 0026U is a Proprietary Laboratory Analyses (PLA) code that identifies ThyroSeq® version 3, a laboratory-specific molecular diagnostic assay for evaluation of thyroid nodules. As a PLA code, 0026U is tied to a unique test made by a specific developer and is used to distinguish this proprietary genomic assay in billing and coverage discussions. Nationally, PLA codes matter because they allow payers, providers, and labs to track and manage utilization and reimbursement for novel laboratory-developed tests.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context, typical sites of service, and the payers commonly engaged in coverage and reimbursement for laboratory molecular diagnostics. The analysis also highlights common modifiers used with laboratory billing and identifies where data was not available in the input.

This publication provides benchmarks and policy-relevant information useful for billing staff, laboratory managers, and policy analysts: recognition of the PLA designation and its implications for tracking test use, the expected clinical application for thyroid nodule evaluation, and payer coverage landscape at a national level. Data not available in the input includes specific associated taxonomies, ICD-10 diagnoses, related codes, and service line detail beyond the laboratory context.