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    v1.0.30
    OpenPayerBilling CodesProprietary Laboratory AnalysesCPT cpt-0216u-ataxia-repeat-expansion-sequence-analysis
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    CPT 0216U: Genomic Unity Ataxia Repeat Expansion and Sequence Analysis

    CPT code 0216U is a Proprietary Laboratory Analyses (PLA) code for the Genomic Unity® Ataxia Repeat Expansion and Sequence Analysis assay from Variantyx Inc., a genomic test that detects tandem repeat expansions and performs sequence analysis across 12 loci to aid diagnosis of hereditary ataxia; service type: specialized molecular/genetic laboratory diagnostic testing; typical site of service: clinical or reference molecular diagnostic laboratory (ordered by neurologists or geneticists, specimen collected in outpatient clinics or hospital outpatient phlebotomy).

    For related coverage guidance, see recent payer policy updates: Oral Cancer Screening and Testing, RTM Testing for Alpha-1 Antitrypsin Deficiency, Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policy.

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    Clinical & Coding Specifications

    Clinical Context

    A patient in their 20s–60s presents to a neurology clinic with progressive gait instability, imbalance, dysarthria, and/or coordination difficulties. The neurologist documents a clinical suspicion for hereditary or sporadic ataxia and orders specialized genetic testing to evaluate tandem repeat expansions and sequence variants across multiple ataxia-associated loci. A blood specimen is collected in an outpatient phlebotomy suite or ambulatory clinic and sent to Variantyx Inc. for the Genomic Unity® Ataxia Repeat Expansion and Sequence Analysis reported under 0216U. Results are reviewed by the ordering neurologist or geneticist to confirm a diagnosis of repeat expansion–associated ataxia, guide genetic counseling, family testing, and management decisions. Typical site of service: outpatient neurology clinic, specialty genetic clinic, or independent clinical laboratory performing PLA testing.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    81292Huntingtin (HTT) (e.g., Huntington disease) gene analysis; detection of CAG repeat expansionsAnother repeat expansion test used in differential diagnosis when chorea or mixed movement disorder is present; may be ordered if clinical features overlap.
    81324FMR1 (fragile X mental retardation 1) (e.g., fragile X syndrome); CGG repeat analysisFragile X–associated tremor/ataxia syndrome can present with ataxia; testing may be performed in parallel for broader differential.
    81479Unlisted molecular pathology procedureUsed when a specific proprietary PLA lacks a direct crosswalk or when additional custom molecular testing is ordered alongside 0216U.
    0018UBrain tumor molecular profiling (example PLA)Other PLA codes illustrate laboratory-specific proprietary testing workflows; billed separately when applicable.
    99213Office or other outpatient visit for the evaluation and management of an established patientRepresents the outpatient clinical visit where ordering, consent discussion, and result review occur; billed by the clinician ordering 0216U.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2084P0800X
    2086S0102X
    207Q00000X
    363L00000X
    2080P0210X
    175M00000X
    261QF0050X
    332100000X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    E55.9Vitamin D deficiency, unspecified
    E83.50Unspecified disorder of calcium metabolism
    E89.0Postprocedural hypothyroidism
    F07.81Postconcussional syndrome
    F44.4Conversion disorder with motor symptom or deficit
    G10Huntington's disease
    G11.3Cerebellar ataxia with defective DNA repair
    G11.4Hereditary spastic paraplegia
    G11.8Other hereditary ataxias
    G21.8Other secondary parkinsonism

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Genetic & Molecular Testing1 / 3

    10 rows

    PolicyPayerEffective Date
    Oral Cancer Screening and TestingOscar Health2027-01-01
    RTM Testing for Alpha-1 Antitrypsin DeficiencyOscar Health2027-01-01
    Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policybcbsvermont2027-01-01
    Carrier Testing Panels for Genetic Diseases (for Kentucky Only)UnitedHealthcare2026-10-01
    Genetic Testing for Neurological Disorders (for Kansas Only)UnitedHealthcare2026-10-01
    Cell-Free Fetal DNA Testing (for Idaho Only)UnitedHealthcare2026-10-01
    Genetic and Molecular TestingProvidence Health Plan2026-10-01
    Next Generation Sequencing for Minimal Residual Disease DetectionProvidence Health Plan2026-10-01
    Pharmacogenetic Panel Testing (for Kansas Only)UnitedHealthcare2026-10-01
    Pharmacogenetic Panel TestingColorado Rocky Mountain Health Plans2026-10-01

    Related Codes

    CPT-0001U-PRECISETYPE-HEA-MULTIPLEX-RBC-ANTIGEN-GENOTYPING

    CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

    CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

    CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

    CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

    CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

    CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

    CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression test

    CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

    CPT 0007U: ToxProtect Urine Drug Screen With DNA Authentication

    CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

    CPT 0008U: H. pylori Antibiotic Resistance Gene Panel

    CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

    CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

    CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

    CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

    CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

    CPT 0011U: Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

    CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

    CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcripts

    Showing 1–10 of 536

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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