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.
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.
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Service type: Proprietary laboratory genetic testing (pharmacogenomic panel)
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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. |