Summary & Overview
CPT 0297U: Praxis Somatic Whole Genome Sequencing
Headline: New PLA CPT code 0297U designates Praxis Somatic Whole Genome Sequencing for tumor-normal paired specimens
CPT code 0297U is a Proprietary Laboratory Analyses (PLA) code that identifies Praxis Somatic Whole Genome Sequencing, a next-generation sequencing (NGS) test performed by Praxis Genomics LLC on paired normal and malignant specimens (blood, bone marrow, or fresh/FFPE tissue). The code matters nationally as whole genome somatic profiling increasingly informs precision oncology care and payer coverage decisions for advanced genomic diagnostics.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose and service context for 0297U, plus what to expect in payer consideration: coverage relevance for cancer diagnosis and somatic variant detection, typical sites of service (laboratory and outpatient specimen collection), and common billing modifiers used with complex laboratory services. The publication outlines benchmark topics and policy-related themes readers can explore further, such as payer adoption of PLA codes, coding documentation requirements, and clinical scenarios where whole genome somatic sequencing may be applied.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and detailed payer-specific policy language.
Billing Code Overview
CPT code 0297U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to a single laboratory test: Praxis Somatic Whole Genome Sequencing, performed by Praxis Genomics LLC. The test evaluates paired normal and malignant (tumor) specimens from the patient, such as blood, bone marrow, or fresh or formalin–fixed paraffin–embedded (FFPE) tissue, using next-generation sequencing (NGS) of the whole genome to aid in the diagnosis of somatic changes associated with various types of cancer.
Service type: Clinical diagnostic laboratory test (proprietary whole genome somatic sequencing)
Typical site of service: Clinical laboratory or hospital outpatient/ancillary specimen collection sites, with specimens collected from blood, bone marrow, or tissue (fresh or FFPE).
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of metastatic solid tumor undergoes a diagnostic workup after progression on first-line therapy. The oncology team obtains paired specimens (tumor tissue from a core needle biopsy of a liver metastasis and a peripheral blood sample for matched normal DNA) to perform comprehensive somatic genomic profiling. The ordered test is Praxis Somatic Whole Genome Sequencing (0297U) performed by the originating laboratory. Specimens are collected in the clinic or interventional radiology suite, processed by the pathology team, and shipped to the proprietary laboratory. Results, including somatic single-nucleotide variants, insertions/deletions, structural variants, copy-number alterations, and tumor mutational burden, are reported to the treating oncologist to inform diagnosis, prognosis, experimental therapy eligibility, and targeted therapy selection. Typical sites of service include hospital outpatient departments, oncology infusion centers, pathology laboratories, and independent reference laboratories.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard reporting | Use when no special circumstance applies to the billed service. |
22 |