Summary & Overview

CPT 0173U: Psych HealthPGx Panel Pharmacogenomic Test

CPT code 0173U designates the Psych HealthPGx Panel, a Proprietary Laboratory Analyses (PLA) test from RPRD Diagnostics that sequences variants in 14 genes to inform psychiatric medication selection. As a PLA code, 0173U applies to a single manufacturer-specific laboratory test and is important for clinicians, laboratories, and payers because it identifies a discrete, proprietary diagnostic service used in precision psychiatry. Nationally, pharmacogenomic testing for psychiatric medications is a growing component of personalized medicine and can affect prescribing choices and care pathways.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise review of the code's clinical purpose, typical site of service, and how this PLA code is categorized within billing systems. The publication outlines payer coverage landscapes, common modifiers associated with laboratory billing when available, and clinical context for use of multi-gene pharmacogenomic panels in psychiatry. The content summarizes benchmarks and policy considerations relevant to proprietary lab tests, and highlights where data is available and where input did not provide details. Data not available in the input is explicitly noted in applicable sections.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicare0173UCPTProprietary Laboratory Analysespharmacogenomicspsychiatrygenetic testinglaboratoryprecision medicine

Billing Code Overview

CPT code 0173U is a Proprietary Laboratory Analyses (PLA) code for the Psych HealthPGx Panel test from RPRD Diagnostics. The test evaluates gene sequence variants across 14 genes to inform decisions about appropriate psychiatric therapies. This panel is a specialized laboratory diagnostic service intended to aid medication selection and management for patients with psychiatric conditions.

Service type: Proprietary laboratory genetic testing (pharmacogenomic panel)
Typical site of service: Clinical laboratory or independent diagnostic testing facility (samples collected in outpatient clinics, physician offices, or via phlebotomy services)

Clinical & Coding Specifications

Clinical Context

A 32-year-old patient with a history of major depressive disorder and partial response to two prior antidepressant trials presents to an outpatient psychiatric clinic for medication optimization. The treating psychiatrist orders the Psych HealthPGx Panel (0173U) from RPRD Diagnostics to evaluate clinically actionable gene sequence variants across 14 pharmacokinetic and pharmacodynamic genes. The clinic collects a buccal swab (or blood sample depending on kit) during the visit and sends the specimen to the laboratory. The lab performs targeted sequencing and reports genotype-to-phenotype interpretations, variant calls, and medication-specific guidance to inform selection or dosing of antidepressants, antipsychotics, mood stabilizers, or adjunctive agents. Results are reviewed in follow-up; the psychiatrist documents genotype results in the medical record, discusses implications with the patient, and adjusts therapy as clinically indicated. Typical sites of service include outpatient psychiatric clinics, primary care offices managing mental health, and clinician laboratories associated with RPRD Diagnostics. The service type is specialized lab-based genetic testing (Proprietary Laboratory Analysis) performed by the manufacturer-specific laboratory.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier; standard reporting	Use when no special circumstance or component attribution applies.

Taxonomy Code	Specialty	Notes
2084P0800X	Psychiatry & Neurology	Psychiatrists ordering and interpreting panel results.
207Q00000X	Family Medicine	Primary care clinicians managing psychiatric medications and ordering testing.
208D00000X	Clinical Pathology	Laboratory directors overseeing genetic testing operations.
2085R0200X	Clinical Genetics	Clinical geneticists or pharmacogenomics specialists involved in complex interpretation.
363L00000X	Genetic Counseling	Genetic counselors providing counseling on results and medication implications.

ICD-10 Code	Description	Clinical Relevance
`F32.9`	Major depressive disorder, single episode, unspecified	Common indication for pharmacogenomic testing to guide antidepressant selection and dosing.
`F33.1`	Major depressive disorder, recurrent, moderate	Recurrent depression with inadequate response to prior trials where PGx may inform next-step therapy.
`F41.1`	Generalized anxiety disorder	Anxiety disorders frequently co-occur with depression and may affect medication choice; PGx can inform anxiolytic and antidepressant management.
`F31.3`	Bipolar disorder, current episode depressed, moderate	Mood stabilizer and antipsychotic selection and metabolism can be informed by pharmacogenomic results.
`F20.9`	Schizophrenia, unspecified	Antipsychotic selection and dosing may be influenced by pharmacogenomic results related to metabolism and receptor pharmacodynamics.
`Z13.79`	Encounter for screening for other genetic and chromosomal anomalies	Used when ordered as part of a genetic screening/screening encounter related to medication selection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0173U`	Psych HealthPGx Panel — targeted sequencing of 14 genes for psychiatric therapy guidance (Proprietary Laboratory Analyses)	Primary billing code for the Psych HealthPGx Panel performed by RPRD Diagnostics.
`81002`	Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen; non-automated, without microscopy	May be ordered in baseline workup for medication monitoring when indicated prior to initiating certain psychotropic agents.
`36415`	Collection of venous blood by venipuncture	Common specimen collection CPT when blood is used for the genetic test instead of buccal swab.
`99000`	Handling and/or conveyance of specimen for transfer from clinical site to laboratory	Used when separate specimen handling services are billed for shipping to the performing lab.
`99401`	Preventive medicine counseling and/or risk factor reduction intervention(s) for an individual; approximately 15 minutes	Used when brief counseling about pharmacogenomic test results and medication options is furnished as a separate service, if applicable.

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