Summary & Overview
CPT 0392U: Medication Management Neuropsychiatric Pharmacogenomic Panel
CPT code 0392U designates a Proprietary Laboratory Analyses (PLA) test — the Medication Management Neuropsychiatric Panel by RCA Laboratory Services LLC d/b/a GENETWORx. The assay uses a buccal swab for targeted sequencing of 16 genes and CYP2D6 copy-number analysis to report gene–drug interaction impacts for psychiatric medications. This code matters nationally as precision prescribing and pharmacogenomics grow in mental health care, influencing medication selection and adverse event risk mitigation.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the test’s clinical purpose and service setting, typical payer coverage landscape, and the types of benchmarks and policy considerations commonly relevant to PLA pharmacogenomic codes. The publication covers coverage patterns and reimbursement considerations for proprietary lab tests, coding nuances for PLA entries, and clinical context for use in medication management for neuropsychiatric conditions. Data not available in the input for specific coverage determinations, associated taxonomies, and ICD-10 mappings will be noted where applicable.
Billing Code Overview
CPT code 0392U is a Proprietary Laboratory Analyses (PLA) code that applies to a single, specific laboratory test: the Medication Management Neuropsychiatric Panel performed by RCA Laboratory Services LLC d/b/a GENETWORx. The test uses a buccal (cheek) swab specimen and performs targeted sequence analysis of 16 genes plus CYP2D6 duplication/deletion analysis. Results report the impact of gene–drug interactions for individual psychiatric medications based on the patient’s genetics and other relevant factors.
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Service type: Genetic testing; pharmacogenomic medication management panel
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Typical site of service: Clinical laboratory using buccal swab specimen collection (ambulatory clinic, outpatient collection site, or specialized phlebotomy/collection center)
Clinical & Coding Specifications
Clinical Context
A 34-year-old outpatient with a history of major depressive disorder and partial response to selective serotonin reuptake inhibitors presents to a psychiatric clinic for medication optimization. The treating psychiatrist orders the Medication Management Neuropsychiatric Panel (0392U) from RCA Laboratory Services LLC d/b/a GENETWORx to inform psychotropic selection and dosing. A buccal swab is collected in clinic or at an affiliated phlebotomy site; the specimen is sent to the performing lab for targeted sequence analysis of 16 pharmacogenes plus CYP2D6 duplication/deletion analysis. The laboratory report returns genotype-based drug–gene interaction interpretations and actionable guidance on drug selection and dosing for psychiatric medications. The clinical workflow includes: patient consent for genetic testing, collection of a buccal swab, completion of laboratory requisition with clinical indication, specimen shipment to GENETWORx, result review by the ordering clinician, and documentation of results and resultant medication management decisions in the medical record.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default professional and technical component globally billed | Use when no specific component modifier applies and the service is billed normally by a single entity. |
26 | Professional component | Use when only the professional interpretation/reporting component is billed separately by the performing clinician or laboratory director. |
TC | Technical component | Use when only the technical component (laboratory processing) is billed by the performing laboratory. |
52 | Reduced services | Use when the laboratory test is partially performed or a reduced service is rendered relative to full test scope. |
53 | Discontinued procedure | Use when specimen collection or testing was started but discontinued for documented clinical reasons. |
59 | Data not in input — not listed; Data not available in the input. | Data not available in the input. |
62 | Two surgeons — not typically applicable to lab testing | Use if multiple providers of record require designation; rarely used for lab PLA codes. |
78 | Unplanned return to the operating/procedure room — not typically applicable to lab testing | Reserved for intraoperative events; generally not applicable to 0392U. |
80 | Assistant surgeon — not applicable to laboratory testing | Not applicable to PLA lab services except in documentation when clinical teams require it. |
QX | Certified provider-performed microscopy — listed in raw modifiers; limited lab relevance | Use when a separately credentialed technical service is performed per payer policy; rarely used for this genetic PLA. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207Q00000X | Psychiatry & Neurology | Psychiatrists ordering pharmacogenomic testing to guide psychiatric medication management. |
| 208000000X | Pathology & Laboratory Medicine | Clinical pathologists or laboratory directors overseeing genetic test performance and interpretation. |
| 207L00000X | Neurology | Neurologists ordering pharmacogenomic testing for neuropsychiatric medication management. |
| 363L00000X | Genetic Counseling | Genetic counselors who provide pre- and post-test counseling and interpretation of results. |
| 207R00000X | Family Medicine | Primary care physicians who may order pharmacogenetic panels for medication management. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
F32.9 | Major depressive disorder, single episode, unspecified | Common indication for psychotropic medication optimization guided by pharmacogenomic testing. |
F33.1 | Major depressive disorder, recurrent, moderate | Used when recurrent depression requires medication adjustments informed by genetic testing. |
F41.1 | Generalized anxiety disorder | Pharmacogenomic data can inform selection/titration of anxiolytic and antidepressant medications. |
F20.9 | Schizophrenia, unspecified | Antipsychotic selection and dose considerations may be influenced by pharmacogenomic results. |
F90.9 | Attention-deficit hyperactivity disorder, unspecified | Stimulant and adjunct medication choices sometimes informed by pharmacogenetic profiles. |
Z13.79 | Encounter for other screening for genetic and chromosomal anomalies | Used when ordering pharmacogenomic screening panels for medication management purposes. |
F43.21 | Adjustment disorder with depressed mood | Short-term medication choices may be informed by pharmacogenomic testing results. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0392U | Medication Management Neuropsychiatric Panel — proprietary PLA by GENETWORx, targeted sequence of 16 genes plus CYP2D6 CNV analysis | Primary test described; reports gene–drug interaction impacts for psychiatric medications. |
0001M | Pharmacogenomic testing, targeted genotyping (example PLA) — placeholder for other PLA pharmacogenomic tests | Other pharmacogenomic PLA tests may be performed alternatively or in addition, depending on laboratory availability and payer policy. |
81162 | CYP2D6 (cytochrome P450 2D6) common variants analysis | Single-gene code commonly used when only CYP2D6 testing is performed rather than a multi-gene PLA panel. |
81225 | HLA-B gene analysis (relevant for some drug hypersensitivity) | Performed when additional pharmacogenetic risk (e.g., HLA-associated hypersensitivity) is clinically relevant alongside psychiatric pharmacogenomics. |
88271 | Microbial identification/signature — Data not in input — not directly related to genetic PLA | Data not available in the input. |