Summary & Overview
CPT 0136U: +RNAinsight™ for ATM Targeted mRNA Sequence Analysis
CPT code 0136U designates the proprietary +RNAinsight™ for ATM test from Ambry Genetics, a targeted mRNA sequence analysis used to improve classification of genetic variants in the ATM gene. As a PLA code, 0136U maps to one uniquely identified laboratory assay and is reported separately in addition to the primary procedure code when performed. Its clinical relevance lies in aiding interpretation of variants linked to ataxia telangiectasia and related hereditary conditions, which can impact diagnostic clarity and downstream clinical management.
Key national payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical purpose, typical sites of service, and the context in which the test is billed. The report also summarizes payer coverage considerations, common modifiers used with the service, and what information is available about associated taxonomies and diagnoses. This publication is intended to provide clinicians, laboratory billing staff, and policy analysts with a clear reference for coding and documenting this specific proprietary molecular diagnostic assay at a national level.
Billing Code Overview
CPT code 0136U is a Proprietary Laboratory Analyses (PLA) code that applies to a single, manufacturer‑specific laboratory test. Report 0136U for the +RNAinsight™ for ATM test from Ambry Genetics, a targeted mRNA sequence analysis designed to improve variant classification of the ATM (ataxia telangiectasia mutated) gene. This test supports classification of genetic variants relevant to ataxia telangiectasia and related hereditary conditions.
Service type: Targeted mRNA sequence analysis for variant classification of a single gene.
Typical site of service: Clinical laboratory or reference genetics laboratory setting performing specialized molecular diagnostics.
Clinical & Coding Specifications
Clinical Context
A patient with a personal or family history of early-onset breast cancer, pancreatic cancer, melanoma, or a known familial ATM (ataxia telangiectasia mutated) variant is referred for germline genetic testing. Prior DNA sequencing identified an ATM variant of uncertain significance (VUS) or a likely pathogenic variant requiring RNA-level analysis to clarify splicing or transcript effects. The ordering clinician (often a geneticist, genetic counselor, or oncologist) collects a blood sample or appropriate tissue specimen and sends it to Ambry Genetics for the proprietary +RNAinsight™ for ATM test. The laboratory performs targeted mRNA sequence analysis to evaluate abnormal splicing, exon usage, or transcript-level consequences, generating a report that may change variant classification and influence surveillance, risk-reduction counseling, and cascade testing for relatives. Typical workflow: clinician orders test and documents the indication in the medical record; phlebotomy or specimen collection at an outpatient clinic or hospital; specimen shipped under laboratory instructions; Ambry Genetics performs the PLA test; results communicated to ordering provider, who incorporates findings into management and genetic counseling. Typical site of service: outpatient clinic, genetic counseling center, or independent/contracted phlebotomy facility; laboratory processing occurs at the performing laboratory.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component separate from the technical laboratory component, if applicable and payer allows. |