Summary & Overview
CPT 0229U: Colvera® Blood Test for BCAT1 and IKZF1 Methylation
CPT code 0229U designates the Colvera® Proprietary Laboratory Analyses (PLA) blood test, which detects methylation of BCAT1 and IKZF1 to assess residual or recurrent colorectal cancer after treatment. As a PLA code, 0229U is specific to a single manufacturer and test, which concentrates oversight and reimbursement considerations around one proprietary assay. The code matters nationally because molecular surveillance tests like Colvera® are increasingly used to guide post-treatment monitoring and may influence follow-up imaging and clinical decision-making.
Key payers in the national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for using a blood-based methylation assay in colorectal cancer surveillance, typical sites of service and laboratory workflows, and what to expect in payer coverage discussions. The publication summarizes benchmark themes, common modifier usage, and implementation considerations for billing and claims submission for a PLA test. Data not available in the input is noted where applicable, and the report focuses on national patterns and policy implications rather than state-level specifics.
Billing Code Overview
CPT code 0229U is a Proprietary Laboratory Analyses (PLA) code for the Colvera® blood test produced by ColveraClinical Genomics Pathology Inc. The test analyzes a blood specimen from a patient treated for colorectal cancer to detect methylation of the BCAT1 and IKZF1 genes, biomarkers associated with colorectal tumor tissue. Clinicians may use results to evaluate the presence of residual disease or to monitor for recurrent colorectal cancer.
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Service type: Proprietary laboratory molecular diagnostic test for post-treatment surveillance of colorectal cancer
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Typical site of service: Clinical laboratory performing specialized molecular testing; specimen collected from the patient via blood draw in an outpatient clinic, infusion center, or hospital phlebotomy setting
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of stage II–III colorectal adenocarcinoma completed surgical resection and adjuvant chemotherapy six months earlier and is now undergoing routine post-treatment surveillance. The treating oncologist orders the Colvera® proprietary circulating tumor DNA (ctDNA) assay (report with CPT code 0229U) on a peripheral blood specimen to evaluate for methylation of the BCAT1 and IKZF1 genes. The clinical workflow: the clinic phlebotomy team draws a timed blood specimen, labels and packages it per the laboratory’s kit instructions, and ships it to ColveraClinical Genomics Pathology Inc. The reference laboratory performs the proprietary methylation analysis and returns a structured report indicating presence or absence and quantitative measures of methylated BCAT1/IKZF1. The oncologist reviews results in the electronic medical record at the next surveillance visit and uses the findings, along with imaging, CEA testing, and clinical exam, to inform discussions about residual disease risk and need for additional diagnostic workup or closer follow-up. Typical site of service is an outpatient clinic, ambulatory oncology practice, or a commercial reference laboratory; specimen collection occurs in an outpatient phlebotomy setting or ambulatory infusion/clinic area.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier used/complete service | Use when no additional modifier applies; report 0229U alone for the complete PLA test. |
26 | Professional component | Use when reporting only the professional interpretation component separate from technical laboratory processing (rare for proprietary PLA tests billed by a single lab). |
TC | Technical component | Use when reporting only the technical component if split billing occurs between specimen processing lab and interpreting provider. |
52 | Reduced services | Use if the laboratory performed a modified or partial analysis that is medically necessary and less than standard protocol. |
53 | Discontinued procedure | Use if specimen was drawn but testing discontinued for clinical reasons prior to completion. |
59 | Data not provided in input | Data not available in the input. |
QK | CLIA waived test performed by provider | Use when applicable for modifiers indicating limited lab scope as defined by payer policy (rare for PLA tests). |
QX | Data not provided in input | Data not available in the input. |
QY | Data not provided in input | Data not available in the input. |
SH | Data not provided in input | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RG0102X | Medical Oncology | Medical oncologists order surveillance molecular assays and interpret results in the context of systemic therapy planning. |
| 207RH0000X | Surgical Oncology | Surgical oncologists use results when evaluating residual disease risk after resection. |
| 2084P0205X | Hematology/Oncology | Hematology/oncology specialists involved in longitudinal cancer surveillance. |
| 363L00000X | Laboratory Director | Pathology or laboratory medicine leadership overseeing test validation and reporting. |
| 207K00000X | Radiation Oncology | Radiation oncologists may use results when assessing local recurrence risk planning post-treatment surveillance. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C18.9 | Malignant neoplasm of colon, unspecified | Primary colorectal cancer diagnosis for which post-treatment surveillance with Colvera® may be used. |
C19 | Malignant neoplasm of rectosigmoid junction | Anatomically related colorectal malignancy monitored for recurrence with molecular assays. |
C20 | Malignant neoplasm of rectum | Rectal cancer patients use ctDNA methylation testing in surveillance for residual/recurrent disease. |
Z85.038 | Personal history of malignant neoplasm of large intestine | Used when monitoring a patient with prior colorectal cancer for recurrence. |
R97.8 | Other abnormal tumor markers | Elevated or monitored tumor markers, often assessed alongside ctDNA results. |
Z90.49 | Acquired absence of other parts of digestive tract | Relevant for patients post-resection where surveillance for recurrence is ongoing. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
80053 | Comprehensive metabolic panel | Often ordered concurrently for baseline organ function monitoring in oncology surveillance prior to further interventions. |
82607 | Alpha-fetoprotein (AFP) | Tumor marker testing that may be part of broader surveillance panels, though not specific to colorectal cancer. |
82378 | CEA, carcinoembryonic antigen | Common serum tumor marker used alongside ctDNA assays to monitor for colorectal cancer recurrence. |
88184 | Flow cytometry, each additional marker | Data not available in the input. |
0000U | Data not provided in input | Data not available in the input. |