Summary & Overview
CPT 0174U: LC–MS/MS Targeted Proteomic Assay for FFPE Solid Tumors
CPT code 0174U identifies a proprietary LC–MS/MS Targeted Proteomic Assay from OncoOmicDx Laboratory that quantifies 30 proteins in FFPE tissue of solid organ tumors. As a PLA (Proprietary Laboratory Analyses) code, 0174U applies exclusively to a single, manufacturer-specific laboratory test, which has implications for coding specificity, payer recognition, and clinical reporting. Nationally, PLA codes like 0174U are important for capturing advanced, proprietary diagnostics used in oncology and precision medicine.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical purpose, typical site of service, and service type, along with payer coverage considerations and common billing modifiers. The publication provides benchmarks and policy context relevant to proprietary laboratory tests, including coding guidance, payer coverage patterns, and operational considerations for laboratories and billing teams.
This summary is intended for a national audience of laboratory managers, coding and billing professionals, and oncology clinicians seeking a clear explanation of what CPT code 0174U represents and how it is positioned within current diagnostic and reimbursement frameworks.
Billing Code Overview
CPT code 0174U is a Proprietary Laboratory Analyses (PLA) code for the LC–MS/MS Targeted Proteomic Assay performed by OncoOmicDx Laboratory. The test uses liquid chromatography–mass spectrometry (LC–MS/MS) to quantify a panel of 30 proteins from formalin–fixed paraffin–embedded (FFPE) tissue of solid organ tumors. This assay is specific to a single manufacturer's laboratory-developed test and the CPT PLA designation indicates that the code maps to one unique test.
Service type: Laboratory — specialized proteomic assay
Typical site of service: Clinical laboratory using FFPE tumor tissue (pathology/laboratory setting)
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a newly diagnosed solid organ malignancy (for example, non-small cell lung carcinoma or colorectal adenocarcinoma) undergoes surgical resection or core needle biopsy. Formalin-fixed paraffin-embedded (FFPE) tumor tissue is submitted to the pathology lab. The OncoOmicDx Laboratory performs an LC–MS/MS targeted proteomic assay that quantifies a panel of 30 proteins to support tumor characterization, prognostic assessment, or therapeutic guidance. Typical workflow: tissue accessioning and pathology confirmation of tumor content → microdissection or enrichment of tumor cells as needed → FFPE section preparation and protein extraction → targeted LC–MS/MS analysis at OncoOmicDx Laboratory using the proprietary assay reported with PLA code 0174U → generation of a molecular proteomic report integrated with pathology findings for the treating oncologist and multidisciplinary tumor board. Typical site of service is an independent clinical reference laboratory or hospital-based molecular pathology laboratory that receives specimens collected in the outpatient clinic, ambulatory surgery center, or inpatient operating room.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier information | Rarely used; placeholder when no additional modifier applies |