Summary & Overview
CPT 0460U: RightMed Oncology Gene Report, 24-Gene SNP Genotyping
CPT code 0460U designates the RightMed® Oncology Gene Report from OneOme® LLC, a proprietary laboratory test that performs DNA single–nucleotide polymorphism (SNP) genotyping across 24 genes using whole blood or buccal swab specimens and reports phenotype interpretations. As a PLA code, 0460U applies only to this specific manufacturer's assay and is used to identify genetic variants and inferred phenotypes with potential relevance to oncology pharmacogenomics and therapeutic decision-making. Nationally, PLA codes like 0460U matter because they enable capture of proprietary molecular testing distinct from non-proprietary panels, and they inform coverage, billing, and comparative utilization discussions.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical and billing context for the assay, payer coverage considerations, common claim modifiers, and where the test is typically performed. The publication also summarizes benchmark topics and policy implications relevant to proprietary genetic testing, including coding specificity, site-of-service considerations, and the role of PLA codes in claims processing. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 0460U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to the RightMed® Oncology Gene Report from OneOme® LLC. The test uses a whole blood or buccal (cheek) swab specimen and performs DNA single–nucleotide polymorphism (SNP) genotyping of 24 genes to identify nucleotide variations. The report includes phenotype interpretations derived from the genotyping results, providing observable-trait information relevant to oncology pharmacogenomics and related clinical decision support.
Service Type: Genetic/SNP genotyping laboratory test (proprietary PLA test)
Typical Site of Service: Clinical laboratory or independent diagnostic testing facility (specimen collected in ambulatory settings or sent from clinic to laboratory)
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult oncology patient preparing for systemic cancer therapy where medication selection and dosing may be influenced by germline pharmacogenomic variants. The clinician orders the RightMed® Oncology Gene Report (0460U) from OneOme® LLC when reviewing medication-related risk for chemotherapy agents, targeted therapies, supportive care medications (e.g., antiemetics, analgesics), or when a history of unusual drug toxicity or treatment failure suggests pharmacogenomic contribution. A sample (whole blood or buccal swab) is collected during an outpatient oncology clinic visit or at a phlebotomy laboratory. The specimen is sent to the performing laboratory. Results report SNP genotypes across 24 genes and derived phenotypes (e.g., poor, intermediate, normal, rapid metabolizer) and are reviewed by the treating oncologist, pharmacist, or genetics team to inform drug selection, dose adjustments, and clinical monitoring. Typical sites of service include outpatient hospital clinics, ambulatory surgery centers for ancillary testing coordination, independent phlebotomy laboratories, and physician office laboratories. Common clinical workflow steps: order placement in the electronic health record, specimen collection and shipment, laboratory genotyping and analysis, report release into the chart, and clinician review with documentation of any medication management decisions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard submission | Use for routine reporting of the single proprietary test without special circumstances. |
22 | Increased procedural services | Use when there is documented substantial additional work beyond typical reporting, documented in the medical record. |
52 | Reduced services | Use when the test is partially performed or reported with reduced components, with documentation of limitation. |
53 | Discontinued procedure | Use when specimen collection or testing was started but terminated for documented reasons prior to completion. |
26 | Professional component | Use when billing only the professional component (interpretation/report) separate from technical component. |
TC | Technical component | Use when billing only the technical component (laboratory processing) separate from professional interpretation. |
59 | Distinct procedural service | Use when another unrelated service is performed on the same day and documentation supports separate reporting. |
76 | Repeat procedure by same provider | Use when the same provider repeats specimen collection/testing later the same day or another day. |
77 | Repeat procedure by another provider | Use when a different provider repeats the test and separate billing is required. |
91 | Repeat clinical diagnostic laboratory test | Use when test is repeated on a new specimen for verification of results; append to the repeat service. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RH0000X | Hematology/Oncology | Medical oncologists ordering pharmacogenomic testing to guide systemic therapy. |
| 207Q00000X | Medical Oncology | Oncology subspecialists treating solid tumors who integrate pharmacogenomic data. |
| 208000000X | Clinical Pathology | Pathologists or laboratory directors overseeing test validation and reporting. |
| 3336C0004X | Clinical Pharmacology | Clinical pharmacists interpreting pharmacogenomic results and advising dosing. |
| 2080N0004X | Clinical Genetics | Clinical geneticists or genetic counselors assisting with phenotype interpretation and patient counseling. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0022U | Pharmacogenomic testing services (example PLA code for other PGx tests) | Other proprietary pharmacogenomic assays that may be ordered alternatively or in addition; useful for comparison in test selection. |
81025 | Urine pregnancy test, by visual color comparison methods | Often performed prior to certain chemotherapies where pregnancy status impacts treatment; may be ordered same-day in oncology workflows. |
82962 | Glucose, blood by glucose monitor system, per patient encounter | Point-of-care tests commonly performed in oncology clinics for monitoring while therapies are being adjusted based on genotypic risk. |
88342 | Immunohistochemistry, per single antibody stain | Tumor biomarker testing performed alongside germline pharmacogenomic testing as part of comprehensive therapeutic planning. |
96372 | Therapeutic, prophylactic, or diagnostic injection (subcutaneous or intramuscular) | Administration of supportive medications or chemotherapy agents where pharmacogenomic results inform agent selection or dosing. |