Summary & Overview
CPT 0130U: +RNAinsight for ColoNext, 10-Gene mRNA Panel for Hereditary Colon Cancer
CPT code 0130U designates a Proprietary Laboratory Analyses (PLA) test: the +RNAinsight™ for ColoNext® from Ambry Genetics. This targeted mRNA sequence analysis panel assesses 10 genes to help classify variants associated with hereditary colon cancer disorders. As a PLA code, 0130U identifies a single manufacturer-specific laboratory test and is reported in addition to the primary procedure code. Nationally, PLA codes like 0130U matter because they standardize reporting for proprietary genomic tests and support clinical interpretation and billing transparency for complex molecular diagnostics.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical purpose of the test, typical site of service, and how this PLA code is used in conjunction with primary procedure codes. The publication outlines payer coverage context, common billing modifiers associated with molecular laboratory services, and the clinical rationale for using mRNA-based assays to improve variant classification in hereditary colon cancer. It also provides benchmarks and policy-relevant considerations for proprietary lab tests, including coding practices, reporting expectations, and payer engagement for molecular diagnostics. Data not available in the input is noted where specific payer policies, associated taxonomies, ICD-10 diagnoses, and related codes are required.
Billing Code Overview
CPT code 0130U is a Proprietary Laboratory Analyses (PLA) code for the +RNAinsight™ for ColoNext® test from Ambry Genetics. This code applies to a targeted mRNA sequence analysis panel of 10 genes used to improve variant classification for genes implicated in hereditary colon cancer disorders. Report 0130U separately in addition to the code for the primary procedure.
Service type: Targeted mRNA sequence analysis (proprietary laboratory test)
Typical site of service: Clinical diagnostic laboratory
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient with a family history of colorectal cancer and a prior identification of a variant of uncertain significance (VUS) in a colon cancer–associated gene is referred for further molecular characterization. The clinician orders the Ambry Genetics +RNAinsight™ for ColoNext® test to evaluate RNA splicing and transcript effects across a targeted 10-gene mRNA panel to improve variant classification for hereditary colorectal cancer syndromes. Specimen collection is typically a peripheral blood draw or a properly preserved blood tube shipped to the performing laboratory. The laboratory performs targeted mRNA extraction, reverse transcription, and sequence analysis to detect aberrant splicing or expression changes related to DNA variants identified by prior germline testing. Results are reported to the ordering genetics provider or genetic counselor, who integrates the RNA findings with prior DNA test results, family history, and clinical data to inform variant reclassification and management decisions. Typical sites of service include outpatient genetic counseling clinics, specialty oncology/genetics clinics, and reference laboratory facilities. The service is billed as an add-on Proprietary Laboratory Analysis using 0130U in addition to the primary DNA/genetic testing CPT code.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional interpretation component if separated from the technical laboratory processing and the payer requires split billing. |