CPT 0091U: FirstSightCRC™ CTC and cfDNA Test for Colorectal Neoplasia

CPT code 0091U is a Proprietary Laboratory Analyses (PLA) code for the FirstSightCRC™ test from CellMax Life that isolates and analyzes circulating tumor cells (CTCs) and cell-free DNA (cfDNA) from a whole blood specimen and reports results as positive or negative for colorectal adenoma or cancer; service type: molecular diagnostic blood test (liquid biopsy); typical site of service: clinical laboratory or outpatient phlebotomy collection setting.

Customize your policy alerts

Sign up for cpt 0091U policy alerts

Get alerted when payer policies referencing 0091U are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Explore openpayer tools

View all tools

CPT 0091U: FirstSightCRC™ CTC and cfDNA Test for Colorectal Neoplasia

Customize your policy alerts

Sign up for cpt 0091U policy alerts

Get alerted when payer policies referencing 0091U are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A typical patient is an average-risk adult or a patient with intermediate risk for colorectal neoplasia who declines or is unable to undergo colonoscopy, or in whom a noninvasive triage test is requested. The patient presents to a primary care clinician or gastroenterology clinic for colorectal cancer screening or evaluation of nonspecific lower gastrointestinal symptoms (for example, intermittent rectal bleeding, change in bowel habits, unexplained weight loss, or iron-deficiency anemia). A blood specimen (whole blood) is collected in an outpatient phlebotomy setting or clinic, labeled, and shipped to the performing laboratory under appropriate chain-of-custody conditions. The FirstSightCRC™ test from CellMax Life isolates circulating tumor cells and cell-free DNA from the specimen; the laboratory performs proprietary analysis and reports a binary result (positive or negative for adenoma or cancer). Results are returned to the ordering clinician who uses them to guide need for diagnostic colonoscopy or further evaluation. Typical site of service is an outpatient clinic, ambulatory phlebotomy center, or commercial laboratory specimen collection site. Typical patient scenario: a 58-year-old patient who declines stool-based screening or colonoscopy and elects blood-based screening; sample is collected during a routine office visit and sent to the performing laboratory for processing and reporting.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Commonly performed immediately prior to sending a whole blood specimen for the FirstSightCRC™ test; used for outpatient sample collection.
`99000`	Handling and/or conveyance of specimen for transfer from patient to laboratory (list separately in addition to services)	May be reported when specific facility or courier handling fees apply separate from the laboratory PLA test.
`G2023`	Specimen collection for pathological examination (non-specific) — (Note: payer-specific code examples)	May be used by some payors for specimen collection or transport billing when local policies require a G-code; check payor rules.
`81479`	Unlisted molecular pathology procedure	Sometimes used historically for novel laboratory tests before PLA codes existed; relates as an alternative if PLA code not recognized by a payor.
`99070`	Supplies and materials provided by physician over and above those usually included with the service	Used when additional specialized collection materials or kits required for the proprietary test are supplied and separately billable.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 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…
57	CPT® modifier -57 (“Decision for Surgery”) is appended to an Evaluation and Management (E/M) service when that encounter results in the initial decision to perform a major surgery (a procedure with a…	- Use modifier 57 when an E/M service provided by the same provider (or same tax ID) on the day of or the day before a major surgical procedure (90‑day global period) results in the initial decision…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family 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…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
364SC2300X	Chronic Care Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
207ZH0000X	Hematology (Pathology) Physician	A hematopathologist is expert in diseases that affect blood cells, blood clotting mechanisms, bone marrow and lymph nodes. This physician has the know…
344600000X	Taxi	A land commercial vehicle used for the transporting of persons in non-emergency situations. The vehicle meets local, county or state regulations set f…
225XF0002X	Feeding, Eating & Swallowing Occupational Therapist	Occupational therapists provide interventions to clients of all ages with feeding, eating and swallowing difficulties. Occupational therapists provid…

Related ICD-10-CM Codes

25 rows

ICD-10-CM Code	Description
C17.9	Malignant neoplasm of small intestine, unspecified
C18.2	Malignant neoplasm of ascending colon
C18.9	Malignant neoplasm of colon, unspecified
C19	Malignant neoplasm of rectosigmoid junction
C20	Malignant neoplasm of rectum
D12.0	Benign neoplasm of cecum
D12.6	Benign neoplasm of colon, unspecified
D12.7	Benign neoplasm of rectosigmoid junction
K50.90	Crohn's disease, unspecified, without complications
K51.90	Ulcerative colitis, unspecified, without complications

Showing 1–10 of 25

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression test

CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

CPT 0007U: ToxProtect Urine Drug Screen With DNA Authentication

CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

CPT 0008U: H. pylori Antibiotic Resistance Gene Panel

CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

CPT 0011U: Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcripts

Showing 1–10 of 536

Frequently Asked Questions

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36415`	Collection of venous blood by venipuncture	Commonly performed immediately prior to sending a whole blood specimen for the FirstSightCRC™ test; used for outpatient sample collection.
`99000`	Handling and/or conveyance of specimen for transfer from patient to laboratory (list separately in addition to services)	May be reported when specific facility or courier handling fees apply separate from the laboratory PLA test.
`G2023`	Specimen collection for pathological examination (non-specific) — (Note: payer-specific code examples)	May be used by some payors for specimen collection or transport billing when local policies require a G-code; check payor rules.
`81479`	Unlisted molecular pathology procedure	Sometimes used historically for novel laboratory tests before PLA codes existed; relates as an alternative if PLA code not recognized by a payor.
`99070`	Supplies and materials provided by physician over and above those usually included with the service	Used when additional specialized collection materials or kits required for the proprietary test are supplied and separately billable.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 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…
57	CPT® modifier -57 (“Decision for Surgery”) is appended to an Evaluation and Management (E/M) service when that encounter results in the initial decision to perform a major surgery (a procedure with a…	- Use modifier 57 when an E/M service provided by the same provider (or same tax ID) on the day of or the day before a major surgical procedure (90‑day global period) results in the initial decision…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family 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…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
364SC2300X	Chronic Care Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
207ZH0000X	Hematology (Pathology) Physician	A hematopathologist is expert in diseases that affect blood cells, blood clotting mechanisms, bone marrow and lymph nodes. This physician has the know…
344600000X	Taxi	A land commercial vehicle used for the transporting of persons in non-emergency situations. The vehicle meets local, county or state regulations set f…
225XF0002X	Feeding, Eating & Swallowing Occupational Therapist	Occupational therapists provide interventions to clients of all ages with feeding, eating and swallowing difficulties. Occupational therapists provid…

Related ICD-10-CM Codes

25 rows

ICD-10-CM Code	Description
C17.9	Malignant neoplasm of small intestine, unspecified
C18.2	Malignant neoplasm of ascending colon
C18.9	Malignant neoplasm of colon, unspecified
C19	Malignant neoplasm of rectosigmoid junction
C20	Malignant neoplasm of rectum
D12.0	Benign neoplasm of cecum
D12.6	Benign neoplasm of colon, unspecified
D12.7	Benign neoplasm of rectosigmoid junction
K50.90	Crohn's disease, unspecified, without complications
K51.90	Ulcerative colitis, unspecified, without complications

Showing 1–10 of 25

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression test

CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

CPT 0007U: ToxProtect Urine Drug Screen With DNA Authentication

CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

CPT 0008U: H. pylori Antibiotic Resistance Gene Panel

CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

CPT 0011U: Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcripts

Showing 1–10 of 536

Frequently Asked Questions

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 0091U: FirstSightCRC™ CTC and cfDNA Test for Colorectal Neoplasia

Sign up for cpt 0091U policy alerts

OpenPayer

CPT 0091U: FirstSightCRC™ CTC and cfDNA Test for Colorectal Neoplasia

Sign up for cpt 0091U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

CPT 0091U: FirstSightCRC™ CTC and cfDNA Test for Colorectal Neoplasia

Sign up for cpt 0091U policy alerts

CPT 0091U: FirstSightCRC™ CTC and cfDNA Test for Colorectal Neoplasia

Sign up for cpt 0091U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does CPT 0091U represent?

In what patient scenarios and setting is the FirstSightCRC™ test used?

Which CPT or related codes might be billed alongside 0091U for specimen collection or handling?

What diagnoses are commonly associated with ordering this blood-based colorectal test?

Does the page indicate payer coverage or reimbursement rates for 0091U?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does CPT 0091U represent?

In what patient scenarios and setting is the FirstSightCRC™ test used?

Which CPT or related codes might be billed alongside 0091U for specimen collection or handling?

What diagnoses are commonly associated with ordering this blood-based colorectal test?

Does the page indicate payer coverage or reimbursement rates for 0091U?

References