Summary & Overview
CPT 0171U: MyMRD NGS Panel for MRD Detection in Myeloid Malignancies
CPT code 0171U designates a Proprietary Laboratory Analyses (PLA) test — the MyMRD® NGS Panel from the Laboratory for Personalized Molecular Medicine — that uses blood or bone marrow to identify minimal residual disease (MRD) by sequencing mutation hotspots across 23 genes implicated in myeloid malignancies such as acute myeloid leukemia (AML), myeloproliferative neoplasms (MPN), and myelodysplastic syndromes (MDS). As a PLA code, 0171U applies to a single manufacturer’s/test developer’s unique assay and signals the growing role of high-sensitivity NGS MRD testing in hematologic oncology.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find national-level context on clinical application of NGS-based MRD detection, the PLA code’s significance for lab billing and payer interactions, and an outline of topics typically addressed in coverage and reimbursement reviews. The publication summarizes benchmarks for utilization and coverage patterns where available, highlights policy and coding considerations specific to PLA-designated assays, and explains clinical scenarios where MRD testing influences disease monitoring and treatment planning.
Data not available in the input for certain fields such as associated taxonomies, specific ICD-10 diagnoses, and related billing codes is noted where applicable elsewhere in the publication.
Billing Code Overview
CPT code 0171U is a Proprietary Laboratory Analyses (PLA) code for the MyMRD® NGS Panel test offered by the Laboratory for Personalized Molecular Medicine. The test uses a blood or bone marrow specimen and applies next-generation sequencing (NGS) to detect minimal residual disease (MRD) by targeting mutation hotspots in 23 genes associated with myeloid malignancies, including acute myeloid leukemia (AML), myeloproliferative neoplasms (MPN), and myelodysplastic syndromes (MDS).
Service type: Laboratory diagnostic testing (Proprietary Laboratory Analyses / NGS-based MRD assay)
Typical site of service: Clinical laboratory processing with specimen collection in outpatient clinics, inpatient settings, or specialized oncology centers
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a history of acute myeloid leukemia (AML) in first complete remission presents for routine post‑treatment surveillance. The treating hematologist orders the MyMRD® NGS Panel (Proprietary Laboratory Analyses code 0171U) using a peripheral blood specimen to detect minimal residual disease (MRD) by targeted next‑generation sequencing of mutation hotspots in 23 myeloid‑associated genes. The clinical workflow: the outpatient clinic collects a blood draw (or, when clinically indicated, a bone marrow aspirate) with appropriate specimen labeling and sends it to the Laboratory for Personalized Molecular Medicine. The laboratory performs NGS library preparation, targeted sequencing, bioinformatic alignment, and variant calling focused on mutation hotspots; results include detected variant allele fractions, qualitative MRD interpretation, and a report returned to the ordering hematologist. Indications include post‑induction or post‑transplant MRD surveillance, assessment after change in therapy for myelodysplastic syndromes (MDS) or myeloproliferative neoplasms (MPN), and workup for suspected early relapse. Typical sites of service are outpatient clinic phlebotomy, outpatient oncology infusion suites, hospital outpatient laboratories, or inpatient hematology wards when a bone marrow specimen is required. Turnaround time and testing frequency depend on clinical scenario and treating physician orders; results inform risk stratification, decisions about additional therapy, and timing of further monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default, no modifier | Use when no specific modifier applies to the laboratory service. |
26 | Professional component | Use when reporting only the professional component for services with distinct professional work (rare for PLA tests but applicable if separate professional interpretation is billed). |
52 | Reduced services | Use when testing was partially performed or a limited version of the service was furnished. |
53 | Discontinued procedure | Use when specimen collection began but the test was cancelled prior to completion for clinical reasons. |
62 | Two surgeons | Use when two providers from different specialties share substantial surgical work (not typical for PLA; included only if surgical procedures accompany testing). |
78 | Unplanned return to OR | Use when an unplanned re‑operation occurs related to specimen collection complications (rare). |
80 | Assistant surgeon | Use when an assistant surgeon is billed for a related operative procedure (rare for this test alone). |
82 | Assistant surgeon when qualified resident not available | Use when an assistant surgeon is required and a resident is not available (rarely applicable). |
AD | Physically disabled beneficiary, no charge | Use per payer rules when waived charges apply for a disabled beneficiary. |
TC | Technical component | Use when billing only the technical component of the laboratory test (instrumentation, processing) if separated from professional interpretation. |
QK | CLIA-waived test performed at unaccredited lab | Use only where applicable; most NGS PLA testing is performed in CLIA-certified labs, so this is rarely appropriate. |
QX | Modifier indicating services performed by a certified nurse‑midwife or other practitioner (applicable per payer rules) | Use per payer rules when specimen collection or related service is performed by such practitioners and modifiers are required. |
QY | Ordering/referencing laboratory test performed elsewhere | Use when the ordering lab references results from another lab or when billing arrangements require this modifier. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RH0000X | Hematology | Hematologists commonly order MRD NGS panels for AML, MDS, and MPN surveillance. |
207RC0000X | Medical Oncology | Medical oncologists treating hematologic malignancies order and interpret MRD testing to guide therapy. |
2084P0800X | Pathology — Molecular Genetic Pathology | Molecular genetic pathologists oversee NGS testing, validation, and interpretation of complex molecular reports. |
363L00000X | Clinical Laboratory | Clinical laboratory directors and technologists perform technical aspects of NGS testing in the lab. |
207K00000X | Hematopathology | Hematopathologists integrate molecular MRD results with morphology and flow cytometry for comprehensive hematologic assessment. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C92.0 | Acute myelogenous leukemia not having achieved remission | MRD testing monitors disease burden and informs therapeutic decisions in non‑remitted AML. |
C92.02 | Acute myelogenous leukemia, in relapse | MRD testing assesses molecular disease activity during relapse or reinduction therapy. |
C92.10 | Chronic myelomonocytic leukemia not having achieved remission | Myeloid neoplasms such as CMML may be monitored with targeted NGS panels for residual mutations. |
D46.9 | Myelodysplastic syndrome, unspecified | MRD and mutation tracking guide risk stratification and treatment planning for MDS. |
D47.Z9 | Myeloproliferative disorder, unspecified | NGS MRD panels help detect driver mutations and residual disease in MPNs. |
Z85.711 | Personal history of acute leukemia | Surveillance MRD testing is used in patients with prior AML to detect early molecular relapse. |
T86.81 | Complication of bone marrow transplant | Post‑transplant patients frequently undergo MRD monitoring to detect relapse or graft failure. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0171U | MyMRD® NGS Panel — Proprietary Laboratory Analyses for MRD targeting 23 myeloid genes using blood or bone marrow specimen | Primary PLA code describing the NGS MRD assay performed by the Laboratory for Personalized Molecular Medicine. |
36415 | Collection of venous blood by venipuncture | Performed in outpatient or inpatient settings to obtain the peripheral blood specimen for the MyMRD® test. |
38000 | Blood collection, venous, by venipuncture; for therapeutic purposes or multi‑component collections (used variably) | May be used when specialized blood collection procedures accompany testing; commonly 36415 is used for routine draws. |
38220 | Bone marrow biopsy, aspiration and/or biopsy for diagnostic purposes, each site | Used when a bone marrow aspirate/biopsy is collected as the specimen source for MRD testing instead of peripheral blood. |
81225 | BCR-ABL1, major breakpoint, quantitative — example of molecular diagnostic CPT (used for workflow context) | Represents other molecular diagnostic assays commonly coordinated with NGS MRD testing in hematologic malignancy management. |
88305 | Pathology examination, surgical pathology, gross and microscopic, non‑gynecologic | Used when bone marrow core biopsies require pathology evaluation alongside molecular testing; commonly reported by pathologists. |