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    v1.0.30
    OpenPayerBilling CodesProprietary Laboratory AnalysesCPT cpt-0474u-geneticsnow-comprehensive-germline-pan-cancer-panel
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    CPT 0474U: GeneticsNow Comprehensive Germline Pan–Cancer Panel

    CPT code 0474U is a Proprietary Laboratory Analyses (PLA) code reported only for the GeneticsNow® Comprehensive Germline Panel from GoPath Diagnostics Inc., a hereditary pan–cancer genomic sequencing test that analyzes 88 genes associated with inherited cancer syndromes using next-generation sequencing and Sanger sequencing on blood or saliva samples; results report positive or negative findings for sequence variants and specified duplications/deletions for each gene. The service type is genetic hereditary pan-cancer genomic sequencing with variant detection, and the typical site of service is a clinical laboratory performing molecular diagnostic testing (specimen: blood or saliva).

    For related coverage guidance, see recent payer policy updates: Oral Cancer Screening and Testing, RTM Testing for Alpha-1 Antitrypsin Deficiency, Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policy.

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    Clinical & Coding Specifications

    Clinical Context

    A patient referred to genetic counseling for evaluation of hereditary cancer risk undergoes the GeneticsNow® Comprehensive Germline Panel (0474U). The typical patient is an adult with a personal history of cancer (for example, early-onset breast cancer, multiple primary tumors, sarcoma, endocrine tumor, neuroendocrine tumor, or cutaneous melanoma) or with a strong family history of cancers suggesting an inherited predisposition. The clinical workflow: a genetics provider or ordering clinician obtains informed consent and collects a blood or saliva sample, which is sent to GoPath Diagnostics for the GeneticsNow® 88-gene panel. The laboratory performs next-generation sequencing with confirmatory Sanger sequencing and targeted duplication/deletion analysis, and reports each gene as positive or negative for pathogenic germline variants. Results are returned to the ordering clinician and genetic counselor for review, risk assessment, and communication to the patient, with implications for surveillance, cascade testing of relatives, and potential targeted therapies or preventive interventions where applicable.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    81211BRCA1 and BRCA2 full gene sequence analysisFrequently ordered separately or prior to broader panels when focused hereditary breast/ovarian cancer testing is indicated.
    81445Oncology (genetic) panel sequencing, 5-50 genes (NGS)Represents smaller targeted NGS panels that may be used instead of a larger 88-gene panel depending on clinical indication.
    0042UProprietary laboratory test code (example PLA)Other PLA codes may represent single-manufacturer hereditary tests; used in workflows comparing manufacturer-specific offerings.
    89250Specimen processing (molecular pathology, extraction)Represents laboratory specimen processing steps that accompany NGS testing; technical services billed by the performing lab.
    99000Handling and/or conveyance of specimenAdministrative or specimen-handling fees sometimes billed in coordination with specialized lab testing.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208D00000X
    207Q00000X
    363L00000X
    207L00000X
    103T00000X
    261QR0207X
    103TE1000X
    261QM3000X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    C16.9Malignant neoplasm of stomach, unspecified
    C18.9Malignant neoplasm of colon, unspecified
    C25.9Malignant neoplasm of pancreas, unspecified
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
    C43.9Malignant melanoma of skin, unspecified
    C49.9Malignant neoplasm of connective and soft tissue, unspecified
    C50.912Malignant neoplasm of unspecified site of left female breast
    C61Malignant neoplasm of prostate
    C64.9Malignant neoplasm of unspecified kidney, except renal pelvis
    D03.9Melanoma in situ, unspecified

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Genetic & Molecular Testing1 / 3

    10 rows

    PolicyPayerEffective Date
    Oral Cancer Screening and TestingOscar Health2027-01-01
    RTM Testing for Alpha-1 Antitrypsin DeficiencyOscar Health2027-01-01
    Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policybcbsvermont2027-01-01
    Carrier Testing Panels for Genetic Diseases (for Kentucky Only)UnitedHealthcare2026-10-01
    Genetic Testing for Neurological Disorders (for Kansas Only)UnitedHealthcare2026-10-01
    Genetic and Molecular TestingProvidence Health Plan2026-10-01
    Cell-Free Fetal DNA Testing (for Idaho Only)UnitedHealthcare2026-10-01
    Next Generation Sequencing for Minimal Residual Disease DetectionProvidence Health Plan2026-10-01
    Pharmacogenetic Panel Testing (for Kansas Only)UnitedHealthcare2026-10-01
    Non-Covered Genetic Panel TestsProvidence Health Plan2026-10-01

    Related Codes

    CPT-0001U-PRECISETYPE-HEA-MULTIPLEX-RBC-ANTIGEN-GENOTYPING

    CPT 0001U: PreciseType HEA Erythrocyte Antigen Genotyping

    CPT-0002U-POLYPDX-URINE-METABOLOMIC-ASSAY-ADENOMATOUS-POLYP-RISK

    CPT 0002U: PolypDX™ Urine Metabolomic Risk Assay

    CPT-0003U-OVAR-A-NEXT-GENERATION-OVARIAN-CANCER-RISK-ASSAY

    CPT 0003U: Overa (MIA2G) Ovarian Cancer Risk Assay

    CPT-0005U-PROSTATE-EXOSOMEDX-INTELLISCORE-GENE-EXPRESSION-URINE-TEST

    CPT 0005U: ExosomeDx Prostate (IntelliScore) urine gene expression test

    CPT-0007U-TOXPROTECT-URINE-DRUG-SCREEN-WITH-DNA-AUTHENTICATION

    CPT 0007U: ToxProtect Urine Drug Screen With DNA Authentication

    CPT-0008U-H-PYLORI-ANTIBIOTIC-RESISTANCE-SEQUENCING-PANEL

    CPT 0008U: H. pylori Antibiotic Resistance Gene Panel

    CPT-0009U-DEPARRAY-HER2-FISH-TUMOR-CELL-ISOLATION

    CPT 0009U: DEPArray HER2 Tumor‑Cell Isolation with FISH Analysis

    CPT-0010U-BACTERIAL-TYPING-WHOLE-GENOME-SEQUENCING-MAYO-CLINIC

    CPT 0010U: Bacterial Typing by Whole Genome Sequencing, Mayo Clinic

    CPT-0011U-CORDANT-CORE-ALGORITHMIC-ORAL-FLUID-DRUG-TEST

    CPT 0011U: Oral Fluid Drug Test with Algorithmic Steady‑State Comparison

    CPT-0016U-BCR-ABL1-MAJOR-MINOR-FUSION-TRANSCRIPT-TESTING

    CPT 0016U: BCR–ABL1 Major and Minor Breakpoint Fusion Transcripts

    Showing 1–10 of 536

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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