Summary & Overview
CPT 0331U: Optical Genome Mapping for Hematolymphoid Neoplasia
CPT code 0331U designates a Proprietary Laboratory Analyses (PLA) test — Augusta Hematology Optical Genome Mapping from Georgia Esoteric and Molecular (GEM) Laboratory LLC — that applies only to a single manufacturer's laboratory assay. The test employs optical genome mapping (OGM) to identify copy number variants and gene rearrangements associated with hematolymphoid neoplasia, a group of blood and bone–marrow cancers. As a PLA code, 0331U signals a unique clinical assay with implications for molecular diagnosis and care planning in hematologic malignancies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical purpose and typical sites of service, a description of payer coverage scope, and benchmarks where available. The publication summarizes coding context, common billing modifiers, and the significance of a PLA-designated CPT code for laboratory and oncology billing workflows. It also outlines what to expect in terms of clinical application — namely, detection of CNVs and structural rearrangements that can inform diagnosis and therapeutic decision-making in hematolymphoid cancers. Data not provided in the input (such as associated taxonomies, ICD-10 mappings, and payer-specific reimbursement amounts) is noted as not available.
Billing Code Overview
CPT code 0331U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to a single, unique laboratory test: Augusta Hematology Optical Genome Mapping performed by Georgia Esoteric and Molecular (GEM) Laboratory LLC. The test uses optical genome mapping (OGM) to detect copy number variants (CNVs) and gene rearrangements implicated in hematolymphoid neoplasia (blood and bone–marrow cancers).
Service Type: Laboratory diagnostic test using optical genome mapping
Typical Site of Service: Clinical or reference laboratory setting; specimen collection may occur in outpatient clinics or hospital outpatient departments
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with persistent cytopenias and suspected myelodysplastic syndrome (MDS) is referred to a hematologist after abnormal peripheral blood smear and bone marrow biopsy. The hematologist orders Augusta Hematology Optical Genome Mapping performed by Georgia Esoteric and Molecular (GEM) Laboratory LLC to detect copy number variants (CNVs) and structural gene rearrangements not identified by conventional cytogenetics or targeted panels. The clinical workflow: sample collection (peripheral blood or bone marrow aspirate) is sent to GEM Laboratory; the laboratory performs optical genome mapping (OGM) and generates a report detailing CNVs and rearrangements relevant to hematolymphoid neoplasia; the hematologist integrates OGM findings with morphology, flow cytometry, and molecular results to refine diagnosis, risk stratification, and therapy selection. Typical site of service: outpatient hematology clinic or hospital outpatient lab with specimen courier to a reference laboratory. Service type: Proprietary Laboratory Analysis (PLA) — high-complexity, reference laboratory diagnostic test.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default — no modifier | Use when no special reporting modifier is required for the PLA service |
| 26 | Professional component | Use when reporting only the professional interpretation component separate from technical component