Summary & Overview
CPT 0134U: +RNAinsight™ for CancerNext® 18-Gene mRNA Panel
CPT code 0134U identifies a Proprietary Laboratory Analyses (PLA) test — the +RNAinsight™ for CancerNext® assay from Ambry Genetics — a targeted mRNA sequencing panel of 18 genes used to refine variant classification in hereditary cancer–related genes. As a PLA code, 0134U is specific to a unique manufacturer/laboratory test and is billed in addition to the primary procedure code for the related genetic testing.
Nationally, PLA codes like CPT 0134U matter for clinical genetics and molecular diagnostics because they enable specific tracking and reimbursement for proprietary assays that provide additional clinical interpretation value. This affects laboratory billing, payer coverage decisions, and precision-medicine reporting across the country.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns, coding and billing considerations for PLA reporting, clinical context for use in hereditary cancer variant classification, and implications for laboratories and clinicians submitting the test as an add-on service.
Readers will find concise benchmarks for payer adoption, summaries of relevant policy approaches to PLA codes and add-on reporting, and clinical context describing when the 18-gene mRNA panel is used to clarify variant pathogenicity. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 0134U is a Proprietary Laboratory Analyses (PLA) code for the +RNAinsight™ for CancerNext® test from Ambry Genetics. This test is a targeted mRNA sequence analysis panel of 18 genes designed to improve variant classification for genes implicated in hereditary cancer–related disorders.
Service type: Laboratory — targeted mRNA sequence analysis for variant classification
Typical site of service: Clinical laboratory / reference laboratory
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A woman with a personal or family history suggestive of hereditary cancer undergoes germline DNA testing that identifies a variant of uncertain significance (VUS) or an inconclusive result in a cancer predisposition gene (for example BRCA1/BRCA2, MLH1, MSH2, or other hereditary cancer genes). To improve variant classification and assess pathogenicity, the ordering clinician requests targeted mRNA analysis using the RNAinsight™ for CancerNext® assay (0134U). The test is performed by a specialty molecular diagnostic laboratory; a blood or tissue specimen is collected in clinic or a phlebotomy suite and shipped to the performing lab. Results are returned to the ordering genetics provider or specialist and are used to refine variant interpretation and guide genetic counseling, cascade testing of family members, and clinical management decisions such as increased surveillance or risk‑reducing interventions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component if the laboratory separates professional and technical components (rare for PLAs). |
TC |