Summary & Overview
CPT 0169U: NUDT15 and TPMT Genotyping Panel
CPT code 0169U designates a Proprietary Laboratory Analyses (PLA) genotyping panel from RPRD Diagnostics that assesses common variants in the NUDT15 and TPMT genes. These genetic markers influence patient response and risk of toxicity to thiopurine drugs, which are used broadly in oncology (notably acute lymphoblastic leukemia), gastroenterology (inflammatory bowel disease), and transplant medicine. Nationwide, precise genotyping supports safer prescribing and personalized dosing, reducing adverse drug reactions and improving treatment outcomes.
Key payers reviewed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a focused overview of clinical context for the test, typical sites of service, and the types of stakeholders likely to engage with this PLA-coded assay. The publication provides benchmarks and payer coverage patterns where available, clarifies the code’s role in billing workflows, and summarizes recent policy and coding considerations relevant to proprietary laboratory analyses. The content is intended to help clinicians, laboratory managers, and revenue cycle professionals understand the clinical purpose of the assay, common billing contexts, and what information is typically needed for payer adjudication. Data not provided in the input (for example, associated taxonomies, specific ICD-10 diagnoses, or related CPT/HCPCS codes) is noted as unavailable.
Billing Code Overview
CPT code 0169U is a Proprietary Laboratory Analyses (PLA) code that applies to a single, vendor-specific genetic test. Report 0169U for the NT (NUDT15 and TPMT) genotyping panel from RPRD Diagnostics. The test evaluates common variants in the NUDT15 and TPMT genes that can affect toxicity and dosing of thiopurine medications used in conditions such as acute lymphoblastic leukemia (ALL), inflammatory bowel disease (IBD), and organ transplant rejection.
Service Type: Genetic / molecular diagnostic testing (genotyping panel)
Typical Site of Service: Clinical laboratory or specialized molecular diagnostics facility
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 12-year-old patient with newly diagnosed acute lymphoblastic leukemia (ALL) is scheduled to begin maintenance therapy that includes thiopurine drugs (e.g., mercaptopurine). The oncology team orders the NT (NUDT15 and TPMT) genotyping panel (0169U) from RPRD Diagnostics prior to initiating thiopurine therapy to identify common variants that affect drug metabolism and risk of severe myelosuppression. Peripheral blood is collected in an appropriate EDTA tube during a routine clinic visit or hospital admission and sent to the reference laboratory. The laboratory performs targeted genotyping of NUDT15 and TPMT variants and reports results as genotype and interpreted phenotype (e.g., normal, intermediate, or poor metabolizer) with dosing implications and risk of toxicity. The molecular test result is reviewed by the treating oncologist or gastroenterologist, documented in the electronic health record, and used to guide initial thiopurine dosing and monitoring plan. Typical sites of service include outpatient oncology clinics, pediatric hematology clinics, inpatient hospital units, and specialty infusion or transplant clinics. The service type is a laboratory molecular/genetic diagnostic test (Proprietary Laboratory Analyses/PLA).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the professional (interpretation) component if the laboratory separates technical and professional services and a billing entity provides interpretation. |