Summary & Overview
CPT 0179U: cfDNA Molecular Profiling for Non–Small Cell Lung Cancer
CPT code 0179U is a Proprietary Laboratory Analyses (PLA) code for the Resolution ctDx Lung™ test, a cfDNA-based molecular profiling assay for non–small cell lung cancer (NSCLC). As a PLA code, 0179U applies to a single, manufacturer-specific test and identifies an advanced genomic assay used to detect single nucleotide variants, insertions/deletions, fusions, and copy number variations that can inform targeted therapy selection. Nationally, PLA codes like 0179U matter because they signal the growing role of commercial, proprietary diagnostics in oncology care and in payer coverage discussions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the assay, the typical service setting, and which major payers are considered in coverage benchmarking. The publication summarizes relevant reimbursement and coverage context for proprietary molecular diagnostics, highlights common billing and claim considerations for 0179U, and situates the test within current clinical practice for NSCLC molecular profiling. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 0179U is a Proprietary Laboratory Analyses (PLA) code reported for the Resolution ctDx Lung™ test from Resolution Bioscience Inc. The test evaluates cell–free DNA (cfDNA) for single nucleotide variations, insertions and deletions, fusions, and copy number variations that may indicate possible appropriate therapies for non–small cell lung cancer.
Service type: Laboratory — Proprietary molecular diagnostic test
Typical site of service: Reference laboratory or specialized molecular diagnostics laboratory (specimen collected at outpatient or hospital sites and sent to the performing laboratory)
Clinical & Coding Specifications
Clinical Context
A 67-year-old patient with a history of smoking and newly diagnosed non–small cell lung cancer (NSCLC) undergoes molecular profiling to guide systemic therapy. The oncology team orders the Resolution ctDx Lung™ next‑generation sequencing liquid biopsy to analyze circulating cell‑free DNA for single nucleotide variants, insertions/deletions, gene fusions, and copy number variations that inform targeted therapy and clinical trial eligibility. Peripheral blood is drawn in an outpatient oncology clinic or an ambulatory phlebotomy site and shipped to the performing laboratory. The laboratory performs cfDNA extraction, targeted sequencing, bioinformatic analysis, and issues a report that lists clinically actionable alterations, variant allele fractions, and interpretation regarding possible targeted therapies.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional interpretation component separately from the technical testing, if applicable under payer rules. |
52 | Reduced services | Use when the test is partially performed or limited in scope relative to the full service. |
53 | Discontinued procedure | Use when specimen handling or testing was begun but discontinued for clinical reasons. |
62 | Two surgeons | Use when two qualified independent laboratories or performing entities share responsibility for testing (rare for PLAs). |
80 | Assistant surgeon | Generally not applicable to laboratory testing but available when an assistant is relevant per payer policy. |
AD | Medical team participation | Use when multiple physicians share primary responsibility for patient care that relates to ordering or interpreting complex testing. |
QK | Medical direction of two, three, or four technicians | Use when the ordering physician directly supervises multiple lab personnel performing portions of the test under specific payer policies. |
QX | Service performed by a clinical lab technologist under CLIA | Use when a qualified technologist performs the technical portion under CLIA-regulated laboratory supervision. |
QY | Medical direction of one technician | Use when the physician directs a single technician performing the test steps under payer rules. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RC0000X | Medical Oncology | Oncologists commonly order and interpret tumor genomic profiling to guide systemic therapy. |
| 2084P0800X | Hematology & Oncology | Combined specialty that manages cancer care and orders molecular tests. |
| 261QM0800X | Clinical Pathology | Laboratory directors and clinical pathologists oversee molecular testing platforms and result validation. |
| 207K00000X | Pulmonary Disease | Pulmonologists involved in lung cancer diagnosis may order or review results for treatment planning. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung | Primary NSCLC diagnosis prompting comprehensive genomic profiling to guide targeted therapy. |
C34.11 | Malignant neoplasm of upper lobe, right bronchus or lung | Tumor site-specific code commonly used when ordering molecular testing for staging and treatment selection. |
C34.12 | Malignant neoplasm of middle lobe, right bronchus or lung | Site-specific lung cancer diagnosis relevant to therapy decisions informed by genomic results. |
C34.31 | Malignant neoplasm of upper lobe, left bronchus or lung | Left-sided NSCLC variant where tumor genotyping via cfDNA influences systemic therapy selection. |
Z85.118 | Personal history of malignant neoplasm of bronchus and lung | Used when prior lung cancer history prompts molecular surveillance or recurrence evaluation with liquid biopsy. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36415 | Collection of venous blood by venipuncture | Blood draw required to obtain the plasma sample for the cfDNA assay prior to shipping to the performing lab. |
99000 | Handling and/or conveyance of specimen for transfer from the physician to a laboratory | Used when billing for specimen pickup or transport services associated with sending the blood specimen to the reference laboratory. |
G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months | Not typically related; included only if initial evaluation leads to incidental testing orders. |
0000U | Example PLA code placeholder | Data not available in the input. |