Summary & Overview
CPT 0308U: HART CADhs® Plasma Protein Risk Score
CPT code 0308U designates a Proprietary Laboratory Analyses (PLA) test — HART CADhs® from Prevencio Inc. — that measures three plasma proteins and applies an algorithm to produce a risk score for coronary artery stenosis or obstruction. As a PLA code, 0308U maps to a single manufacturer-specific assay and is used where results may affect diagnostic pathways and downstream care decisions for suspected coronary artery disease.
Key payers in the national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns and benchmarks where available, clarifies clinical context for ordering and interpretation, and summarizes relevant policy implications for laboratory and cardiology service lines.
Readers will learn the clinical purpose of the test, typical sites of service and operational considerations for labs and outpatient providers, and which major payers are included in the coverage review. Data limitations where input fields are incomplete are noted explicitly as "Data not available in the input." The goal is to provide a concise reference for billing, coding, and clinical teams evaluating use of CPT code 0308U in practice.
Billing Code Overview
CPT code 0308U is a Proprietary Laboratory Analyses (PLA) code for the HART CADhs® test from Prevencio Inc. The test assesses a plasma specimen for levels of the three proteins named in the code and uses an algorithmic analysis of those results combined with patient data to generate a risk score for coronary artery stenosis or obstruction. The result is intended to inform clinical decision-making related to coronary artery disease evaluation.
-
Service type: Laboratory diagnostic test using plasma specimen with algorithmic risk scoring
-
Typical site of service: Clinical laboratory or diagnostic lab associated with outpatient care
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with atypical chest pain and multiple cardiovascular risk factors (hypertension, hyperlipidemia, and a family history of premature coronary artery disease) presents to a cardiology clinic. The clinician orders the HART CADhs® proprietary blood test to assist in noninvasive risk stratification for obstructive coronary artery disease. A phlebotomy-trained technician collects a plasma specimen in the outpatient laboratory or hospital outpatient phlebotomy area. The specimen is sent to Prevencio Inc. for analysis. Prevencio measures the three specified plasma proteins, integrates the biomarker values with patient clinical data via the proprietary algorithm, and returns a risk score indicating probability of coronary artery stenosis or obstruction. Results are reviewed by the ordering cardiologist or primary care clinician to inform decisions about further testing (for example, coronary CT angiography, functional stress testing, or invasive coronary angiography) and treatment planning. Typical sites of service include outpatient cardiology clinics, hospital outpatient departments, and independent clinical laboratories performing PLA testing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Use when no modifier applies and full global service is reported |
26 | Professional component | Use if billing only for the professional/interpretive component when applicable (rare for PLA but applicable if laboratory separates technical vs professional billing) |
TC | Technical component | Use when billing only for the technical component (laboratory processing) of the test |
52 | Reduced services | Use if the test is partially performed or an abbreviated version is reported due to specimen or processing limitations |
53 | Discontinued procedure | Use if specimen collection or testing was started but discontinued for clinical or specimen reasons |
59 (not in provided list) | Data not available in the input. | |
62 | Two surgeons | Use when two physicians share responsibility for a procedure (generally not applicable to PLA but included when physician roles warrant) |
78 | Unplanned return to operating/procedure | Use when an unplanned repeat procedure occurs related to the original (rare for PLA) |
80 | Assistant surgeon | Use when an assistant surgeon provides services (generally not applicable to laboratory testing) |
82 | Assistant surgeon (when no qualified assistant available) | Use similarly to 80 when applicable |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services | Use when an advanced practice clinician performs or documents specimen collection or order management under applicable rules |
QK | Medical direction of two, three, or four concurrent anesthesia procedures | Data not directly applicable to PLA but included when anesthesia-related billing intersecting with specimen collection occurs |
QX | Surgical assistant - qualified | See QK note; rarely applicable to laboratory procedure context |
QY | Nonphysician health care professional - medical direction | Use when medical direction applies to nonphysician billers involved in specimen handling |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 208000000X | Cardiovascular Disease (Cardiology) | Ordering and interpreting clinicians for coronary risk testing |
| 207RC0000X | Internal Medicine | Primary care physicians ordering pretest risk stratification |
| 363L00000X | Clinical Laboratory | Laboratory performing specimen processing and testing |
| 207P00000X | Family Medicine | Primary care providers managing chest pain evaluation |
| 2086S0102X | Interventional Cardiology | Specialists who may act on test results to proceed to invasive angiography |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I25.10 | Atherosclerotic heart disease of native coronary artery without angina pectoris | Common chronic coronary disease state where risk of obstructive stenosis is assessed with biomarker testing |
I20.9 | Angina pectoris, unspecified | Symptom prompting noninvasive risk stratification for obstructive coronary disease |
I21.9 | Acute myocardial infarction, unspecified | Acute coronary syndrome context in which biomarker panels may support diagnostic pathways (though HART CADhs® is for stable risk assessment) |
R07.9 | Chest pain, unspecified | Common presenting complaint leading to ordering of coronary risk biomarker testing |
E78.5 | Hyperlipidemia, unspecified | Major cardiovascular risk factor relevant to pretest probability for coronary stenosis |
I10 | Essential (primary) hypertension | Cardiovascular risk factor influencing pretest risk stratification |
Z13.6 | Encounter for screening for cardiovascular disorders | Preventive or screening context where biomarker-based risk assessment may be used |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
93000 | Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report | Initial noninvasive cardiac assessment commonly performed before or with biomarker testing |
93015 | Cardiovascular stress test using continuous ECG monitoring (separate procedure) | Functional assessment often used alongside biomarker-based risk stratification for ischemia evaluation |
75571 | Computed tomography, heart, for evaluation of coronary arteries, without contrast (coronary CT angiography codes vary) | Anatomic imaging modality that may be ordered after a high-risk biomarker result to evaluate coronary stenosis |
93458 | Catheter placement in coronary artery for coronary angiography, including imaging when performed | Invasive diagnostic procedure considered when noninvasive testing and biomarker results suggest significant obstructive disease |
81025 | Urine pregnancy test, single | Example preprocedure screening test sometimes required before certain imaging or invasive procedures; may be performed in workflow depending on patient population |