Summary & Overview
CPT 0111U: Praxis Extended RAS Panel for KRAS and NRAS in Colon Cancer
CPT code 0111U designates a Proprietary Laboratory Analyses (PLA) test — the Praxis™ Extended RAS Panel from Illumina — a targeted molecular assay that detects mutations in KRAS and NRAS codons from biopsy tissue. Nationally, such assays matter because KRAS/NRAS mutation status influences diagnostic characterization of colorectal tumors, eligibility for certain therapies, and downstream care decisions, contributing to precision oncology efforts across health systems.
Key payers in the coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. This publication summarizes clinical context for the assay, typical sites of service, and the payer coverage environment as represented by major national carriers.
Readers will learn the clinical purpose of CPT code 0111U, where the service is typically performed, and which major payers are relevant for coverage considerations. The report also outlines what types of benchmarks and policy elements to expect in payer analyses (coverage status variations, prior authorization patterns, and coding/billing considerations) and highlights the clinical implications of reporting KRAS and NRAS mutation results for colon cancer management. Data not available in the input will be flagged as such where relevant.
Billing Code Overview
CPT code 0111U is a Proprietary Laboratory Analyses (PLA) code for the Praxis™ Extended RAS Panel by Illumina. The test is a targeted gene analysis panel that assesses mutations in KRAS and NRAS codons from biopsy tissue. Mutations in these genes are clinically relevant to colon cancer and can inform tumor characterization.
Service Type: Molecular diagnostic targeted gene analysis
Typical Site of Service: Pathology or molecular diagnostics laboratory processing biopsy tissue
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a newly diagnosed adenocarcinoma of the colon undergoes a diagnostic colonoscopy with tumor biopsy. The treating oncologist orders tumor genotyping using the Praxis™ Extended RAS Panel (Illumina) to detect activating mutations in KRAS and NRAS codons that guide anti-EGFR therapy decisions. The surgical pathology laboratory processes the formalin-fixed paraffin-embedded (FFPE) biopsy tissue, extracts DNA, and performs the targeted panel. Results are reported back to the oncology team and incorporated into therapeutic planning, such as eligibility for cetuximab or panitumumab and enrollment in genotype-directed clinical trials. Typical workflow: biopsy acquisition in an outpatient endoscopy suite or operative setting → specimen accessioning and pathology review → molecular test order placed by oncologist/pathologist → specimen sent to the performing laboratory → assay performed and report generated → result reviewed by ordering clinician and multidisciplinary team for treatment decision-making.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component separate from the technical laboratory processing (rare for PLAs but applicable if split billing). |
51 |