Summary & Overview
CPT 0292U: MindX Blood Test – Stress, RNA NGS PTSD Risk Score
CPT code 0292U designates a proprietary laboratory test — the MindX Blood Test™ – Stress from MindX Sciences™ Inc. — that uses RNA next-generation sequencing of 72 genes and an algorithmic analysis to generate a predictive risk score for post‑traumatic stress disorder (PTSD). As a PLA code, 0292U is specific to a single manufacturer's test, which affects how payers and laboratories manage coverage, coding, and claim adjudication nationally.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the test, the laboratory service model and typical site of service, and the implications of PLA designation. The publication summarizes payer coverage patterns and benchmarks, common claim modifiers relevant to laboratory services, and the clinical context surrounding molecular RNA expression testing for PTSD risk prediction.
This report is intended to inform healthcare administrators, coding professionals, and policymakers about how CPT code 0292U is defined, the service it represents, and the operational considerations for billing and coverage at a national level.
Billing Code Overview
CPT code 0292U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to the MindX Blood Test™ – Stress, performed by MindX Sciences™ Laboratory, MindX Sciences™ Inc. The test uses a blood specimen and employs next-generation sequencing (NGS) of RNA to evaluate gene expression activity for 72 genes. An algorithmic analysis of those gene-expression results produces a predictive risk score for post-traumatic stress disorder (PTSD).
Service Type: Clinical laboratory diagnostic test using RNA NGS and algorithmic risk scoring.
Typical Site of Service: Clinical laboratory or reference laboratory with specimen collection occurring in an outpatient blood draw setting.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who has experienced a traumatic event (combat exposure, assault, major accident, or disaster) and presents to a primary care clinician, behavioral health provider, or occupational health clinic requesting objective risk stratification for post‑traumatic stress disorder (PTSD). The clinician documents the history of trauma and baseline symptoms, obtains informed consent for genetic/transcriptomic testing, and orders the MindX Blood Test™ – Stress (0292U) to assist in predictive risk assessment for PTSD. A phlebotomy encounter occurs in an outpatient clinic, hospital outpatient laboratory, or commercial/stand‑alone draw site; a blood specimen is collected, processed, and shipped to MindX Sciences™ Laboratory. The laboratory performs next‑generation RNA sequencing of 72 genes and applies an algorithm to generate a predictive PTSD risk score. Results are returned to the ordering clinician and incorporated into longitudinal care planning, behavioral health referral, or occupational health decisions. Typical sites of service include outpatient physician offices, outpatient hospital departments, and independent diagnostic laboratories operating couriered specimen logistics.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified — default | Use when no other modifier applies and a single service instance is reported. |
26 | Professional component | Use when reporting only the professional component of diagnostic testing, if applicable and billed separately from the laboratory technical component. |
TC | Technical component | Use when reporting only the laboratory technical component of the test; typically appended by the performing lab when split billing is required. |
QK | CLIA waived test performed waived status | Not typical for NGS; include only if specific payer or lab guidance requires CLIA‑related modifier reporting. |
QX | CLIA waived test, non‑waived personnel | Similar CLIA context; apply per payer/lab instructions when personnel qualifications affect billing. |
QY | CLIA moderate complexity | Use per laboratory billing rules when CLIA complexity distinctions are required by payers. |
52 | Reduced services | Use when specimen or testing is limited or partially completed and full testing was not performed. |
53 | Discontinued procedure | Use if the specimen collection or testing was initiated but discontinued for clinical or technical reasons. |
78 | Unplanned return to operating/procedure room | Rare for laboratory testing; use only if an unplanned return to a procedure setting affected sample collection. |
80 | Assistant surgeon | Not typically applicable; included only if an assistant participated in an associated invasive procedure for specimen collection. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services performed in part | Use when advanced practice clinicians perform the specimen collection and payers require this indicator. |
62 | Two surgeons | Not applicable to laboratory test; include only if relevant to a concurrent surgical encounter tied to specimen procurement. |
22 | Increased procedural services | Use if additional, documented work beyond the typical test (for example, complex specimen processing requested by clinician) justifies increased payment and payer accepts modifier for PLA codes. |
26 | Professional component | Use to indicate interpretation or professional analysis portion when separated from the lab's technical component. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207Q00000X | Family Medicine | Primary care clinicians who order testing for patients after traumatic exposure. |
2084P0800X | Clinical Health Psychology | Behavioral health specialists who integrate the test result into PTSD risk assessment and treatment planning. |
208D00000X | Psychiatry & Neurology (Psychiatry) | Psychiatrists ordering testing as part of comprehensive psychiatric evaluation. |
207L00000X | Emergency Medicine | Emergency clinicians who may order testing during initial post‑trauma encounters in select occupational/clinical protocols. |
261QM0800X | Clinical Laboratory Director | Laboratory physicians or laboratory directors responsible for oversight of testing and billing when performed by the laboratory. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
F43.10 | Post-traumatic stress disorder, unspecified | Directly relevant as the test provides a predictive risk score for PTSD. |
F43.11 | Post-traumatic stress disorder, acute | Relevant for assessing risk shortly after traumatic exposure. |
F43.12 | Post-traumatic stress disorder, chronic | Relevant for stratifying ongoing or recurrent PTSD risk. |
Z91.420 | Personal history of psychological trauma, not elsewhere classified | Relevant when documenting prior trauma that informs testing decisions. |
Z56.6 | Other physical and mental stressors related to work | Relevant in occupational health contexts where PTSD risk affects fitness for duty. |
R45.0 | Nervousness and agitation | Symptom code that may prompt consideration of objective risk testing. |
Z02.89 | Encounter for administrative examination, other specified | May be used in pre‑deployment or occupational screening programs that include risk stratification testing. |
Z13.89 | Encounter for screening for other specified diseases and disorders | Relevant when ordering screening or predictive biomarker testing in at‑risk populations. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
80048 | Basic metabolic panel | Routine laboratory testing often performed alongside clinical evaluation when ordering specialized PLA tests. |
36415 | Collection of venous blood by venipuncture | Standard specimen collection procedure used to obtain the blood sample for the 0292U test. |
99000 | Handling and/or conveyance of specimen for transfer from the office to a laboratory | Use when a separate chargeable specimen handling or courier service is provided for off‑site testing. |
G0008 | Administration of influenza virus vaccine | Example of unrelated preventive service that might be provided in the same visit; included to show common concurrent services when applicable. |
81025 | Urine pregnancy test, by dipstick or tablet reagent for pregnancy test | Example of point‑of‑care test that may be performed during the encounter; not directly related to the PLA but commonly co‑performed. |