Summary & Overview
CPT 0290U: MindX Blood Test Pain — RNA NGS 36-Gene Expression Risk Score
CPT code 0290U is a proprietary laboratory analysis (PLA) code that identifies the MindX Blood Test™ – Pain, a blood-based next-generation sequencing (NGS) RNA assay that measures expression of 36 genes and produces an algorithm-derived predictive risk score for pain propensity. As a PLA code, 0290U is unique to MindX Sciences™ Inc. and is intended to enable distinct tracking and payment for this specific molecular diagnostic.
This publication covers national implications for coverage and billing across major payers, with analysis of common national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical purpose of the test, typical sites of service, and the billing context for a proprietary NGS-based RNA expression assay. The report summarizes available payer engagement and coverage themes, identifies common billing and coding considerations for laboratories and clinicians, and outlines the clinical context in which a predictive pain-risk score may be used.
The piece provides benchmarks and policy updates relevant to adoption of PLA molecular tests, explains administrative coding considerations for 0290U, and situates the test within broader trends in precision diagnostics and algorithmic risk scoring. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0290U is a Proprietary Laboratory Analyses (PLA) code that applies only to the single, specific laboratory test identified by the manufacturer. Report 0290U only for the MindX Blood Test™ – Pain performed by MindX Sciences™ Laboratory, from MindX Sciences™ Inc. The test uses a blood specimen and employs next-generation sequencing (NGS) of RNA to evaluate gene expression activity of 36 genes and applies an algorithmic analysis to report a predictive risk score for the propensity for pain.
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Service type: Laboratory molecular diagnostic test using RNA NGS with algorithmic risk scoring
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Typical site of service: Clinical laboratory or reference laboratory (blood specimen collection typically occurs in outpatient phlebotomy settings)
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient with chronic noncancer pain of unclear etiology presents to a pain management clinic. The patient has persistent widespread pain despite trials of first-line therapies and multiple medication adjustments. The clinician orders the MindX Blood Test™ – Pain (0290U) to assess gene expression patterns associated with pain propensity. A blood specimen is collected in the clinic or at an accredited phlebotomy site and shipped to MindX Sciences™ Laboratory. Laboratory processing uses next-generation sequencing of RNA from the blood sample to evaluate expression of 36 genes; an algorithm generates a predictive risk score for propensity for pain. Results are returned to the ordering clinician, who incorporates the score into the overall assessment and care plan, which may include further diagnostic evaluation, personalized pharmacologic selection, referral to physical medicine or behavioral health, or monitoring of treatment response.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; standard reporting | Use for routine reporting of the laboratory test without additions or special circumstances |
| 26 | Professional component | Use when billing only the professional component (interpretation/analysis) of the test separately from the technical component |