Summary & Overview
CPT 0110U: Oral OncolyticAssuranceRX LC–MS/MS Drug Detection
CPT code 0110U designates a Proprietary Laboratory Analyses (PLA) test — the Oral OncolyticAssuranceRX from Firstox Laboratories, LLC — that uses liquid chromatography–tandem mass spectrometry (LC–MS/MS) on serum or plasma from capillary or venous blood to detect and quantify oral oncology drugs and related substances. This code matters nationally as precision pharmacologic monitoring gains importance for oral cancer therapies, adherence assessment, toxicity prevention, and personalized dosing decisions.
Key payers included in the coverage analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes payer coverage approaches, coding and billing implications for laboratories and clinicians, and how this PLA code fits into existing laboratory testing pathways.
Readers will find a concise benchmark of payer coverage policies, an explanation of clinical context for using LC–MS/MS to measure oral oncolytic agents, and a clear summary of administrative considerations tied to a PLA-coded single-manufacturer test. The report highlights technical service details, typical sites of service, and the types of clinical situations where measurement of oral oncology drug levels is relevant. Data not available in the input: associated taxonomies, specific ICD-10 diagnoses, detailed payer policy language, and related or companion billing codes.
Billing Code Overview
CPT code 0110U is a Proprietary Laboratory Analyses (PLA) code for the Oral OncolyticAssuranceRX test produced by Firstox Laboratories, LLC. The test uses liquid chromatography and tandem mass spectrometry (LC–MS/MS) of serum or plasma from a capillary or venous blood specimen to determine the presence, absence, and quantity of one or more oral oncology drug(s) and substances in a patient’s body.
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Service type: Laboratory diagnostic test using LC–MS/MS for therapeutic drug monitoring and detection of oral oncolytic agents.
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Typical site of service: Clinical laboratory or outpatient blood draw collection site (capillary or venous).
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with metastatic colorectal cancer is on oral capecitabine therapy and presents for routine therapeutic monitoring and adherence verification. The treating oncologist orders the Oral OncolyticAssuranceRX test (0110U) to detect and quantify capecitabine and its active metabolites in serum or plasma collected via capillary or venous blood. A phlebotomy or fingerstick specimen is collected at the outpatient oncology clinic or infusion center and sent to Firstox Laboratories, LLC. The laboratory performs liquid chromatography–tandem mass spectrometry (LC–MS/MS) to determine presence/absence and concentration of the oral oncology drug(s). Results are reported to the ordering provider and used to assess adherence, drug exposure, potential drug interactions, or unexpected toxicity before continuing or adjusting oral therapy. Typical sites of service include outpatient oncology clinics, ambulatory surgical centers for oncology care, physician offices, and independent clinical laboratories. Typical supporting documentation includes the order, indication in the medical record, specimen collection time, collection method (capillary vs venous), and signed report from the performing laboratory.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default; no modifier | Use when no other modifier applies and the standard PLA service is furnished. |