Summary & Overview
CPT 0299U: Somatic Optical Genome Mapping for Tumor Structural Variant Analysis
CPT code 0299U designates the Praxis Somatic Optical Genome Mapping test, a Proprietary Laboratory Analyses (PLA) assay that compares paired normal and malignant specimens to detect large-scale structural DNA changes associated with cancer. As a PLA code tied to a single manufacturer's assay, 0299U matters nationally because it enables specific reporting and tracking of a novel optical genome mapping (OGM) technology that may influence diagnostic pathways for hematologic and solid tumor evaluation.
Key payers covered in the 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, typical sites of service, and the service type. The publication presents benchmarks and coverage policy context where available, summarizes payer approaches to PLA and emerging genomic technologies, and outlines clinical considerations relevant to oncology diagnostic workflows.
This report is intended for national audiences of payers, providers, and laboratory administrators seeking clarity on billing, coding, and the clinical role of a proprietary OGM-based somatic test. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0299U is a Proprietary Laboratory Analyses (PLA) code for the Praxis Somatic Optical Genome Mapping test from Praxis Genomics LLC. The test evaluates paired normal and malignant (tumor) specimens from the patient — for example, blood, bone marrow, or frozen tissue — to identify structural changes in large segments of DNA that may be associated with cancer.
Service type: Laboratory — somatic tumor genomic structural variation analysis using optical genome mapping
Typical site of service: Clinical laboratory or specialized molecular diagnostics laboratory
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with newly diagnosed acute myeloid leukemia (AML) undergoes collection of paired specimens—peripheral blood and a bone marrow aspirate—to characterize large structural genomic abnormalities. The oncology team orders the Praxis Somatic Optical Genome Mapping test (0299U) to compare the patient’s normal (peripheral blood) and malignant (bone marrow) DNA using optical genome mapping. Specimens are processed per the laboratory’s instructions: fresh or frozen tissue is shipped to the reference laboratory, where the proprietary assay analyzes large chromosomal rearrangements, copy number changes, and complex repetitive or rearranged DNA regions that may inform prognosis, identify actionable structural variants, and guide selection of targeted therapies or enrollment in clinical trials. Typical workflow: clinician documents indication in the medical record and obtains informed consent; samples are collected in the hospital outpatient infusion center or inpatient unit; specimen accessioning and courier shipment to Praxis Genomics LLC; laboratory performs OGM and issues a report to the ordering oncologist; results are integrated into multidisciplinary tumor board or treatment planning. Typical sites of service include hospital inpatient, hospital outpatient, and independent reference laboratory settings.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier; full global service | Use when no unusual circumstances modify the service. |
26 | Professional component | Use if reporting only the laboratory professional interpretation separate from technical processing when permitted by payer. |
TC | Technical component | Use when reporting the laboratory technical component only, if payers require split billing between facility and professional. |
52 | Reduced services | Use if the laboratory test was partially performed or delivered at a reduced level of service. |
53 | Discontinued procedure | Use if testing was started but halted due to specimen quality or other acceptable reason. |
62 | Two surgeons (interpreting providers) | Use rarely when two independent qualified laboratories or pathologists provide separate, documented interpretive contributions requiring dual billing. |
78 | Unplanned return to operating/procedure room by same physician following initial procedure | Not typical for this test; use only in rare cases of re-collection requiring surgical re-entry. |
80 | Assistant surgeon | Generally not applicable; include only if an assistant performed a billable collection procedure under payer rules. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist as assistant at surgery | Use only if an advanced practice clinician provided a billable assist in specimen collection per payer policy. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures | Not typically applicable to this laboratory service; include when anesthesia direction is separately reportable for collection. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RC0000X | Hematology & Oncology | Ordering and interpreting physicians who manage hematologic malignancies. |
2080P0005X | Clinical Pathology | Pathologists who may interpret complex genomic assay results. |
2080S0004X | Molecular Genetic Pathology | Specialists in molecular and genomic diagnostic testing and interpretation. |
207L00000X | Medical Oncology | Oncologists who incorporate OGM results into therapeutic planning. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C92.0 | Acute myeloblastic leukemia not having achieved remission | Structural genomic alterations detected by OGM can identify prognostic chromosomal rearrangements relevant to AML. |
C90.0 | Multiple myeloma active | OGM may detect complex chromosomal changes in plasma cell disorders that affect prognosis and therapeutic selection. |
C83.9 | Non-Hodgkin lymphoma, unspecified | Structural variants in lymphoid malignancies can be identified by OGM to guide diagnosis and targeted therapy. |
D47.Z2 | Monoclonal gammopathy of undetermined significance (MGUS) | OGM can be used in research or advanced diagnostic workups when progression to malignancy is suspected. |
C84.9 | Cutaneous T-cell lymphoma, unspecified | OGM can detect structural genomic changes in tumor tissue that assist in characterization of lymphoid neoplasms. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
38100 | Bone marrow aspiration or biopsy for collection of specimen | Often performed to obtain the malignant specimen sent for OGM when marrow-derived DNA is required. |
36415 | Collection of venous blood by venipuncture | Commonly used to collect the paired normal (peripheral blood) specimen for comparison. |
88381 | Immunohistochemistry, per single antibody stain | May be performed on tissue samples as adjunctive testing alongside genomic mapping to characterize tumor markers. |
88299 | Cytogenetic analysis, other (unlisted) | Other cytogenetic tests may be ordered in conjunction with OGM for complementary structural variant detection. |
81455 | Genome sequencing procedures, large gene panels (e.g., somatic tumor profiling by NGS) | Frequently ordered together to identify SNVs/indels and small copy-number variants that complement OGM structural variant findings. |