Summary & Overview
CPT 0322U: NPDX ASD Test Panel III, Plasma Metabolomic LC–MS/MS
CPT code 0322U identifies a proprietary laboratory test — the NPDX ASD Test Panel III from Stemina Biomarker Discovery, NeuroPointDX. The assay uses liquid chromatography–tandem mass spectrometry (LC–MS/MS) to quantify metabolism-related plasma compounds and applies an algorithm to report a positive or negative metabolic profile associated with autism spectrum disorder (ASD). As a PLA code, 0322U applies only to this single manufacturer-specific test and is used in claims to distinguish this proprietary diagnostic panel.
Key payers included in this national analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise benchmarks for coverage and coding practices, an overview of clinical context for metabolomic testing in ASD evaluation, and notes on claim submission considerations tied to the PLA designation. The publication summarizes how payers treat manufacturer-specific laboratory assays, common billing practices for proprietary panels, and the implications of algorithm-based binary reporting (positive/negative) for medical necessity and documentation. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0322U is a Proprietary Laboratory Analyses (PLA) code specific to a single laboratory test: the NPDX ASD Test Panel III from Stemina Biomarker Discovery, NeuroPointDX division. The test uses liquid chromatography with tandem mass spectrometry (LC–MS/MS) to measure metabolism-related chemical compounds in a plasma specimen and reports algorithm-driven results as positive or negative for a metabolic profile associated with autism spectrum disorder (ASD).
Service type: Laboratory — Proprietary diagnostic metabolomic panel performed on plasma using LC–MS/MS.
Typical site of service: Clinical laboratory or reference laboratory setting; specimen collection may occur in outpatient clinics or phlebotomy centers.
Clinical & Coding Specifications
Clinical Context
A pediatric or young-adult patient presents to a developmental-behavioral pediatrics or pediatric neurology clinic for evaluation of delayed social communication, restricted/repetitive behaviors, and/or regression in language. After standard developmental screening and diagnostic assessment raises concern for autism spectrum disorder (ASD), the clinician orders the proprietary NPDX ASD Test Panel III (0322U) from Stemina Biomarker Discovery, NeuroPointDX division to evaluate a plasma metabolic profile that may support biochemical subtype identification. A fasting or non-fasting peripheral blood draw is performed in an outpatient laboratory, ambulatory clinic, or reference laboratory phlebotomy site; the plasma specimen is processed and shipped per the manufacturer’s instructions to the performing laboratory. The laboratory uses liquid chromatography–tandem mass spectrometry (LC–MS/MS) and an algorithmic analysis to classify the metabolic profile as positive or negative for an ASD-associated signature. Results are returned to the ordering clinician and incorporated into the diagnostic synthesis and care planning discussion with the patient’s caregivers. Typical sites of service include outpatient hospital-based laboratories, independent clinical reference laboratories, and ambulatory clinic laboratory draw stations. The service type is a proprietary laboratory analysis (PLA) molecular/metabolomic diagnostic test.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |