Summary & Overview
CPT 0287U: ThyroSeq CRC Thyroid NGS Recurrence-Risk Test
Headline: New PLA CPT code 0287U identifies ThyroSeq® CRC, an NGS-based thyroid recurrence-risk test
CPT code 0287U designates ThyroSeq® CRC, a proprietary next-generation sequencing (NGS) laboratory assay developed by CBLPath Inc. and the University of Pittsburgh Medical Center to evaluate 112 genes on thyroid specimens (FNA or FFPE) and report a risk category for cancer recurrence. As a PLA code, 0287U represents a single manufacturer's test and is used in claims to identify this specific molecular diagnostic service.
This publication covers national payer handling for 0287U, focusing on commercial and federal plans. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and the role of the assay in risk stratification; benchmark considerations for coverage and coding; typical sites of service and billing practice points; and a summary of payer-specific considerations where available.
The report is intended to inform revenue cycle, laboratory, and clinical stakeholders about coding identification and the clinical purpose of 0287U, provide benchmark context for payer coverage approaches, and summarize areas where policy updates or clarifications are commonly required. Data not available in the input will be noted as such in detailed sections.
Billing Code Overview
CPT code 0287U is a Proprietary Laboratory Analyses (PLA) code that describes a single, manufacturer-specific laboratory test: ThyroSeq® CRC developed by CBLPath Inc. and the University of Pittsburgh Medical Center. The test uses next-generation sequencing (NGS) on thyroid specimens — such as fine needle aspiration (FNA) samples or formalin–fixed paraffin–embedded (FFPE) tissue — to analyze a 112-gene panel and applies an algorithmic interpretation to report a risk for cancer recurrence as low, intermediate, or high.
Service Type: Laboratory molecular diagnostic testing using NGS for recurrence risk stratification
Typical Site of Service: Clinical laboratory or pathology service, using specimens collected in outpatient or inpatient clinical settings
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a thyroid nodule detected on ultrasound and an indeterminate cytology result from fine needle aspiration (FNA), such as Bethesda category III (AUS/FLUS) or IV (follicular neoplasm/suspicious for follicular neoplasm). The clinician orders the ThyroSeq® CRC assay (0287U) to provide molecular profiling and an algorithmic estimate of risk for cancer recurrence (low, intermediate, or high) using next-generation sequencing of 112 genes on the submitted thyroid specimen (FNA material or FFPE tissue). The specimen is collected in the ambulatory clinic or radiology suite during ultrasound-guided FNA or obtained from surgical pathology (FFPE block) after diagnostic lobectomy. The specimen is sent to the proprietary laboratory (CBLPath/University of Pittsburgh Medical Center) with appropriate accessioning and clinical history. Results guide multidisciplinary decisions about surveillance intensity, need for completion thyroidectomy, radioactive iodine consideration, or referral to endocrine surgery and oncology. Typical sites of service include outpatient clinic, outpatient radiology suite, and hospital pathology laboratory when FFPE material is submitted.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified | Rare; generally not used for laboratory PLA codes but available when no other modifier applies |