Summary & Overview
CPT 0393U: SYNTap® CSF α–synuclein Biomarker Test
CPT code 0393U designates the SYNTap® Biomarker Test, a proprietary cerebrospinal fluid assay that detects misfolded α–synuclein proteins associated with Parkinson’s disease and Lewy body dementia. As a PLA code, 0393U identifies a single manufacturer-specific laboratory test important for diagnostic clarification and research into synucleinopathies. Nationally, availability of this specialized assay affects clinical pathways for suspected neurodegenerative disease and influences laboratory utilization and payer coverage discussions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The summary addresses how payers approach coverage for novel proprietary biomarker tests and highlights implications for clinicians, laboratories, and patients seeking CSF-based diagnostic information.
Readers will learn: the clinical context and service setting for 0393U; common billing and administrative considerations for a PLA laboratory assay; what benchmark coverage categories and policy updates matter for payers listed above; and relevant clinical implications for diagnosing PD and LBD. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes will be noted where applicable in the full publication.
Billing Code Overview
CPT code 0393U is a Proprietary Laboratory Analyses (PLA) code that describes the SYNTap® Biomarker Test from Amprion Clinical Laboratory. The test detects misfolded α–synuclein proteins in a cerebrospinal fluid (CSF) specimen and is used as a biomarker for neurodegenerative diseases such as Parkinson’s disease (PD) and **Lewy body dementia (LBD).
Service Type: Clinical laboratory test — proprietary biomarker analysis.
Typical Site of Service: Hospital outpatient laboratory, independent clinical laboratory, or other settings where CSF collection and laboratory testing are performed.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient presents to a neurology clinic with progressive bradykinesia, rigidity, and episodic visual hallucinations over 18 months. The neurologist documents clinical suspicion for synucleinopathy such as Parkinson disease (PD) or Lewy body dementia (LBD) and orders cerebrospinal fluid testing to support diagnosis. A lumbar puncture is performed in the hospital outpatient or ambulatory surgical center setting to obtain CSF; the specimen is sent to Amprion Clinical Laboratory for the SYNTap® Biomarker Test. The laboratory analyzes the CSF for misfolded α–synuclein using proprietary methods and returns a report indicating presence or absence of seeding activity consistent with synucleinopathy. Results are reviewed by the ordering neurologist and integrated with clinical assessment, imaging, and cognitive testing to inform diagnosis and care planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unmodified procedure | When no modifier applies to the PLA test claim |
26 | Professional component | When billing physician interpretation or professional oversight separate from the laboratory technical component |
TC | Technical component | When billing the laboratory technical component only (test performance and reporting) |
62 | Two surgeons | Rare for this lab test; used if two providers jointly perform the lumbar puncture procedure when reporting associated services |
78 | Return to OR for related procedure | Use when a subsequent procedure related to lumbar puncture requires same-session return (rare for this lab test) |
80 | Assistant surgeon | When an assistant surgeon participated in the lumbar puncture in an operative setting and is reported separately |
52 | Reduced services | When the specimen or testing provided is reduced in scope compared with the full-planned service |
53 | Discontinued procedure | When lumbar puncture is started but discontinued and specimen not obtained for testing |
76 | Repeat procedure by same physician | When the lumbar puncture or CSF collection is repeated by the same provider during the same encounter (use 76 if needed; note: 76 is not in the provided list) |
QK | Medical direction of two or more assistants | If physician-directed medical direction applies to assistants during the procedure setting |
QX | Service performed by an assistant at surgeon's direction | When an assistant (non-physician) performs parts of the service under supervision |
QY | Attending provider not present; teaching physician oversight | When applicable in teaching hospital settings for associated procedures |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist billing - payment made under the physician fee schedule | When an advanced practice clinician orders or collects specimen and bills per applicable rules |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2084P0800X | Neurology | Neurologists commonly order the SYNTap® test for suspected synucleinopathies |
| 207R00000X | Pathology | Pathologists may oversee CSF testing workflows and laboratory result interpretation |
| 208000000X | Family Medicine | Primary care physicians may initiate referral and ordering of diagnostic CSF testing |
| 363A00000X | Clinical Laboratory | Clinical laboratory specialists and directors manage proprietary PLA testing and billing |
| 363LF0000X | Clinical Neurophysiology | Specialists involved in diagnostic workup of neurodegenerative disease may coordinate testing |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
G20 | Parkinson disease | Primary diagnosis for which α–synuclein CSF testing may support classification of synucleinopathy |
G31.83 | Dementia with Lewy bodies | Directly related; test aids in confirming synuclein pathology in suspected LBD |
G31.9 | Degenerative disease of nervous system, unspecified | Used when a neurodegenerative disorder is suspected but not yet classified; CSF biomarker helps refine diagnosis |
R41.82 | Altered mental status, unspecified | Cognitive changes prompting evaluation for neurodegenerative etiology where SYNTap® testing may be ordered |
F02.81 | Dementia in Parkinson disease | Overlapping diagnosis where CSF α–synuclein results may inform disease characterization |
G23.1 | Other specified degenerative diseases of basal ganglia | Disorders with parkinsonism features where synuclein biomarker testing can assist in differentiation |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
62270 | Spinal puncture, lumbar, diagnostic | Procedure to obtain CSF specimen that is submitted for the SYNTap® Biomarker Test |
89051 | Specimen handling; body fluid (e.g., CSF) preparation for transfer to a reference laboratory | Handling and packaging services required when sending CSF to Amprion Clinical Laboratory |
81000 | Urinalysis, by dipstick or tablet; non-automated, with microscopy | Example of laboratory testing often performed in parallel for baseline evaluation (not specific to PLA) |
CPT code not provided | Data not available in the input. | Data not available in the input. |
CPT code not provided | Data not available in the input. | Data not available in the input. |