Summary & Overview
CPT 0461U: RightMed Oncology Medication Report, 24-Gene SNP Panel
CPT code 0461U designates a Proprietary Laboratory Analyses (PLA) test specific to OneOme® LLC’s RightMed® Oncology Medication Report. The assay performs single–nucleotide polymorphism (SNP) genotyping across 24 genes using whole blood or buccal swab specimens and reports phenotypes and predicted gene–drug interactions relevant to oncology medication selection. Nationally, pharmacogenomic panels like this are increasingly used to tailor cancer therapy and anticipate drug response or toxicity, influencing prescribing and care pathways.
Key payers included in the national context are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, the clinical and laboratory service model, and what types of service benchmarks and policy considerations typically apply to PLA genomic testing. The publication outlines how this test fits into the clinical workflow, typical sites of collection and processing, and the implications for coverage determinations and billing practices. Data not provided in the input—such as specific payer coverage policies, reimbursement benchmarks, associated taxonomies, ICD-10 mappings, and related codes—are noted as unavailable in source material.
Billing Code Overview
CPT code 0461U is a Proprietary Laboratory Analyses (PLA) code reported only for the RightMed® Oncology Medication Report from OneOme® LLC. The test uses a whole blood or buccal (cheek) swab specimen and performs single–nucleotide polymorphism (SNP) genotyping of 24 genes. Results report phenotypes and likely gene–drug interactions to help inform provider decision-making about cancer therapy selection and medication management.
Service type: Clinical genomic pharmacogenomic testing (SNP genotyping, targeted panel)
Typical site of service: Clinical laboratory or outpatient clinic where specimen collection occurs (blood draw or buccal swab collection)
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a recently diagnosed solid tumor (e.g., colorectal or breast cancer) is scheduled to start systemic anticancer therapy. The oncology care team orders the RightMed® Oncology Medication Report (0461U) to inform selection and dosing of chemotherapeutic agents and targeted therapies. A buccal cheek swab or whole blood specimen is collected during an outpatient oncology clinic visit or at an external specimen collection site. The sample is sent to OneOme® LLC for proprietary SNP genotyping across 24 pharmacogenes. The laboratory returns a report that translates genotypes to phenotypes and identifies likely gene–drug interactions relevant to oncology medications. The oncologist and clinical pharmacist review the report in the electronic health record, document results in the chart, and use the information to discuss therapy options, dose adjustments, or monitoring strategies with the patient. Typical sites of service include outpatient oncology clinics, hospital outpatient departments, and contracted phlebotomy or specimen collection centers. The service type is specialized pharmacogenomic laboratory testing (Proprietary Laboratory Analyses).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Use when no special circumstances apply to the billed PLA service. |