Summary & Overview
CPT 0387U: AMBLor® Melanoma Prognostic Immunohistochemistry Test
Headline: New CPT code 0387U designates the AMBLor® melanoma prognostic assay, a proprietary immunohistochemistry test that reports a risk score for melanoma progression.
CPT code 0387U identifies a proprietary laboratory analysis that uses immunohistochemistry on FFPE melanoma tissue to measure two biomarkers and produce an algorithm-derived risk score for progression and metastasis. The code matters nationally as an emerging precision pathology tool that may affect clinical decision-making for melanoma surveillance and adjuvant therapy planning.
Key payers addressed in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on the clinical purpose of the assay, its service setting, and the expected coding context. The publication summarizes payer coverage posture where available, benchmarks for utilization and reimbursement ranges when reported by payers, and relevant policy considerations for molecular and proprietary laboratory tests.
The report is organized to help clinicians, laboratory managers, and policy analysts understand: (1) what CPT code 0387U represents clinically; (2) how the test fits into pathology and oncology workflows; and (3) where payers commonly place this type of PLA test in coverage and coding frameworks. Data not available in the input will be identified in dedicated sections.
Billing Code Overview
CPT code 0387U is a Proprietary Laboratory Analyses (PLA) code that describes the AMBLor® melanoma prognostic test from Avero® Diagnostics. The test uses immunohistochemistry staining on a formalin–fixed paraffin–embedded (FFPE) melanoma tissue specimen to identify two biomarkers. An algorithmic analysis of the biomarker levels generates a reported risk score for melanoma progression and metastasis.
Service type: Laboratory pathology – proprietary prognostic immunohistochemistry assay
Typical site of service: Clinical laboratory or pathology laboratory associated with surgical pathology services, using FFPE melanoma tissue from outpatient or inpatient surgical specimens.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents after excisional biopsy of a suspicious cutaneous pigmented lesion on the forearm that was histologically confirmed as primary cutaneous melanoma. The dermatopathologist performs routine histology and immunohistochemistry and forwards a formalin–fixed paraffin–embedded (FFPE) block and representative slides to the molecular pathology/PL lab for prognostic testing. The ordering clinician (dermatologist, surgical oncologist, or medical oncologist) requests the AMBLor® melanoma prognostic test to stratify the patient’s risk of recurrence and distant metastasis based on two immunohistochemical biomarkers quantified from the FFPE specimen. The laboratory receives the specimen, verifies patient and specimen identifiers, performs immunohistochemical staining, quantifies biomarker expression, runs the vendor-specific algorithm, and reports a risk score and interpretive comment to the ordering provider. Typical site of service is an outpatient dermatology clinic or hospital outpatient facility for the biopsy, with the PLA testing performed in a commercial reference laboratory. Turnaround time is commonly several days to two weeks depending on lab workflow. Clinical use of the result informs surveillance intensity and multidisciplinary discussion of adjuvant therapy eligibility and follow-up imaging strategies.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default for billing when no modifier applies | Rarely used; default placeholder when payer-specific modifier required but no other modifier fits |
26 | Professional component | Use when billing only the professional interpretation component separately from the technical lab processing |
TC | Technical component | Use when reporting only the technical component (laboratory testing) if professional interpretation billed separately |
52 | Reduced services | Use if the laboratory performed a partial or limited version of the test (rare for PLA codes) |
53 | Discontinued procedure | Use if specimen processing was started but testing aborted for documented medical/technical reasons |
62 | Two surgeons | Not commonly used for lab testing; included for completeness when surgeon split responsibility occurs for tissue removal |
78 | Unplanned return to OR | Not applicable to lab test itself; may appear on associated surgical claims if re-operation required |
80 | Assistant at surgery | Not applicable to the lab test; may apply to the associated biopsy claim |
QK | Medical direction of qualifying anesthesia personnel | Not applicable to lab testing; rarely associated with operative claims related to tissue acquisition |
QX | CRNA service with medical direction by an anesthesiologist | Not applicable to test; associated to OR services when tissue obtained under anesthesia |
QY | Medical direction of one CRNA by an anesthesiologist | Not applicable to test; associated to OR services |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services | May be used on the specimen collection/biopsy claim when those providers perform the procedure |
SH | Physician assistant services for assistant at surgery | May appear on the surgical biopsy claim when a PA assists in the procedure |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207N00000X | Dermatology | Dermatologists commonly order prognostic melanoma assays after biopsy diagnosis |
| 208000000X | General Surgery | Surgical oncologists perform excision and may order prognostic testing for staging and treatment planning |
| 2086S0105X | Medical Oncology | Medical oncologists use prognostic information to consider adjuvant systemic therapy |
| 207RH0000X | Dermatopathology | Dermatopathologists evaluate specimens and coordinate referral to molecular/PLA labs |
| 261QP2300X | Clinical Laboratory | Clinical laboratory directors and pathologists oversee performance and reporting of PLA tests |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C43.9 | Malignant melanoma of skin, unspecified | Primary diagnostic indication for melanoma prognostic testing |
C43.5 | Malignant melanoma of trunk | Site-specific melanoma diagnosis commonly evaluated with prognostic assays |
C43.4 | Malignant melanoma of lower limb, including hip | Site-specific melanoma where prognostic risk stratification guides surveillance |
C43.3 | Malignant melanoma of upper limb, including shoulder | Site-specific melanoma commonly submitted for prognostic testing |
D03.9 | Melanoma in situ, unspecified | In select cases, immunohistochemical prognostic assays may be considered if invasive features are suspected |
Z85.820 | Personal history of malignant melanoma of skin | Used in follow-up visits and to justify surveillance/prognostic testing in recurrent disease workups |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
88305 | Level IV surgical pathology, gross and microscopic examination | Used for initial histopathologic examination of the excised melanoma specimen prior to ordering PLA testing |
88342 | Immunohistochemistry, each antibody stain (single stain) | Represents individual IHC stains; the PLA test uses IHC but is reported under the proprietary PLA code rather than multiple 88342 entries |
88360 | Morphometric analysis; cytologic quantitative analysis | Ancillary image analysis codes may be used when quantitative biomarker measurement occurs, but PLA 0387U is billed as single proprietary test |
88381 | Special stains or studies; Level 1, per specimen | May be used on the pathology claim for special staining performed locally before sending to reference lab |
88374 | Immunohistochemistry, per specimen; screening (single or multiple antigens) | Local IHC screening claims for diagnostic purposes; prognostic PLA testing is reported with 0387U |