CPT 0266U: Praxis Transcriptome NGS for Heritable Gene Expression

CPT code 0266U is a Proprietary Laboratory Analyses (PLA) code that reports the Praxis Transcriptome test from Praxis Genomics LLC, a next-generation sequencing (NGS) transcriptome analysis performed on specimens such as blood, frozen tissue, or formalin–fixed paraffin–embedded (FFPE) tissue to detect presence or absence of gene expression changes associated with constitutional or other heritable disorders; service type: clinical laboratory molecular diagnostic testing using transcriptome analysis; typical site of service: clinical laboratory or reference testing facility processing blood, frozen tissue, or FFPE specimens.

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CPT 0266U: Praxis Transcriptome NGS for Heritable Gene Expression

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Get alerted when payer policies referencing 0266U are released or updated.

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Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A pediatric or adult patient with a suspected constitutional or heritable genetic disorder is referred for transcriptome testing after initial genetic evaluation. The patient presents with unexplained developmental delay, multiple congenital anomalies, neuromuscular signs, or a family history suggesting a hereditary syndrome. A geneticist, neurologist, or clinical molecular pathologist orders the 0266U Praxis Transcriptome test to evaluate gene expression signatures from a submitted specimen (peripheral blood, frozen tissue, or formalin–fixed paraffin–embedded tissue).

Specimen collection occurs in an outpatient clinic, hospital inpatient unit, or surgical pathology suite depending on the tissue source. For blood, a phlebotomist draws EDTA tube(s) and ships per laboratory instructions. For FFPE or frozen tissue, the surgical team or pathology department prepares and sends the block or fresh/frozen samples with appropriate chain-of-custody and requisition. The laboratory performs RNA extraction, next-generation sequencing (NGS) transcriptome analysis, bioinformatic processing, and clinical interpretation to determine presence or absence of gene expression changes associated with constitutional or heritable disorders. Results report is routed to the ordering clinician for correlation with clinical findings and family counseling. Billing for the proprietary laboratory analysis is reported using 0266U with applicable modifiers to indicate professional/technical components, bilateral procedures, unusual circumstances, or payer-specific reporting requirements.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`83020`	Hemoglobin electrophoresis or related hematologic laboratory test	Preanalytic hematology tests may be performed on blood specimens prior to RNA extraction in complex cases.
`88342`	Immunohistochemistry, per single antigen-antibody stain	Ancillary pathology stains on FFPE tissue that may be performed alongside to phenotype tissue before molecular testing.
`81479`	Unlisted molecular pathology procedure	Used when a specific molecular or genomic test is not represented by a PLA or existing CPT; sometimes used for related custom assays when applicable.
`96372`	Therapeutic, prophylactic, or diagnostic injection	Procedural codes for administration of agents are unrelated but may appear on the same claim for clinic visits where blood is drawn.
`99000`	Handling and/or conveyance of specimen to off-site lab	Applicable when an institution bills separately for specimen transport or special handling associated with sending samples to Praxis Genomics.

Note: The proprietary laboratory analysis described by 0266U is billed specifically for the Praxis Transcriptome test; the codes above represent common ancillary or sequential services in the clinical workflow.

Related Modifiers

5 rows

Modifier	Description	When to Use
26	Modifier 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…
52	Modifier ‑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…
53	Modifier 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…
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
80	CPT® 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	Specialty	Notes
2080P0206X	Pediatric Gastroenterology Physician	A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This speciali…
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
207RE0101X	Endocrinology, Diabetes & Metabolism Physician	An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with …
225500000X	Respiratory/Developmental/Rehabilitative Specialist/Technologist	General classification identifying individuals who are trained on a specific piece of equipment or technical procedure.
103TH0100X	Health Service Psychologist	A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, …

Related ICD-10-CM Codes

23 rows

ICD-10-CM Code	Description
D82.1	Di George's syndrome
E34.9	Endocrine disorder, unspecified
F70	Mild intellectual disabilities
F82	Specific developmental disorder of motor function
F84.0	Autistic disorder
G71.3	Mitochondrial myopathy, not elsewhere classified
I69.398	Other sequelae of cerebral infarction
P94.2	Congenital hypotonia
Q75.8	Other specified congenital malformations of skull and face bones
Q87.0	Congenital malformation syndromes predominantly affecting facial appearance

Showing 1–10 of 23

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

References

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.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.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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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`83020`	Hemoglobin electrophoresis or related hematologic laboratory test	Preanalytic hematology tests may be performed on blood specimens prior to RNA extraction in complex cases.
`88342`	Immunohistochemistry, per single antigen-antibody stain	Ancillary pathology stains on FFPE tissue that may be performed alongside to phenotype tissue before molecular testing.
`81479`	Unlisted molecular pathology procedure	Used when a specific molecular or genomic test is not represented by a PLA or existing CPT; sometimes used for related custom assays when applicable.
`96372`	Therapeutic, prophylactic, or diagnostic injection	Procedural codes for administration of agents are unrelated but may appear on the same claim for clinic visits where blood is drawn.
`99000`	Handling and/or conveyance of specimen to off-site lab	Applicable when an institution bills separately for specimen transport or special handling associated with sending samples to Praxis Genomics.

Related Modifiers

5 rows

Modifier	Description	When to Use
26	Modifier 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…
52	Modifier ‑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…
53	Modifier 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…
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
80	CPT® 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	Specialty	Notes
2080P0206X	Pediatric Gastroenterology Physician	A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This speciali…
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
207RE0101X	Endocrinology, Diabetes & Metabolism Physician	An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with …
225500000X	Respiratory/Developmental/Rehabilitative Specialist/Technologist	General classification identifying individuals who are trained on a specific piece of equipment or technical procedure.
103TH0100X	Health Service Psychologist	A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, …

Related ICD-10-CM Codes

23 rows

ICD-10-CM Code	Description
D82.1	Di George's syndrome
E34.9	Endocrine disorder, unspecified
F70	Mild intellectual disabilities
F82	Specific developmental disorder of motor function
F84.0	Autistic disorder
G71.3	Mitochondrial myopathy, not elsewhere classified
I69.398	Other sequelae of cerebral infarction
P94.2	Congenital hypotonia
Q75.8	Other specified congenital malformations of skull and face bones
Q87.0	Congenital malformation syndromes predominantly affecting facial appearance

Showing 1–10 of 23

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

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 0266U: Praxis Transcriptome NGS for Heritable Gene Expression

Sign up for cpt 0266U policy alerts

OpenPayer

CPT 0266U: Praxis Transcriptome NGS for Heritable Gene Expression

Sign up for cpt 0266U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References