CPT 0498U: OptiSeq Colorectal Cancer NGS Panel

CPT code 0498U is a Proprietary Laboratory Analyses (PLA) code for the OptiSeq™ Colorectal Cancer NGS Panel from DiaCarta Inc., a next-generation sequencing (NGS) test that analyzes mutations in 43 genes and methylation patterns in 45 genes from blood and FFPE tissue to generate a detailed report with interpretation of genetic variants and methylation patterns; service type: NGS-based tumor and circulating biomarker analysis; typical site of service: clinical laboratory or hospital/ancillary pathology laboratory processing blood and formalin-fixed paraffin-embedded (FFPE) tissue specimens.

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CPT 0498U: OptiSeq Colorectal Cancer NGS Panel

Customize your policy alerts

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Get alerted when payer policies referencing 0498U are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 62-year-old individual with a history of colorectal adenocarcinoma who presents for molecular profiling to guide targeted therapy and prognosis. The oncologist orders the OptiSeq™ Colorectal Cancer NGS Panel (0498U) after reviewing prior pathology showing invasive colorectal carcinoma on formalin-fixed paraffin-embedded (FFPE) tumor tissue. Peripheral blood is also collected for circulating tumor DNA (ctDNA) analysis when tumor tissue is limited or to assess minimal residual disease. The laboratory receives the FFPE tissue block or unstained slides and/or a plasma specimen, performs DNA extraction, next-generation sequencing (NGS) targeting 43 genes for somatic mutations and assays methylation patterns across 45 genes, and generates a comprehensive report with variant interpretation, allele frequencies, and methylation results. The clinical workflow includes specimen collection, chain-of-custody documentation, molecular testing under CLIA-certified procedures, analytic validation, pathologist or molecular geneticist review of reportable variants, and electronic delivery of results to the ordering oncologist. Typical clinical uses include selection of targeted therapies, enrollment decisions for clinical trials, prognostic assessment, and monitoring for recurrence using ctDNA when applicable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81479`	Unlisted molecular pathology procedure	Used when a specific proprietary PLA code is not available; for `0498U` the PLA code is reported instead of `81479`.
`88184`	Interpretation of molecular cytogenetic or molecular pathology test results (may be used for separate professional component reporting in some payor policies)	May be reported by the pathologist or molecular geneticist when separate interpretive services are billed; check payer rules for bundling with `0498U`.
`36415`	Collection of venous blood by venipuncture	Used when a peripheral blood specimen is collected for ctDNA analysis accompanying the `0498U` panel.
`88305`	Level III surgical pathology, gross and microscopic examination	Used when pathologist performs initial histopathology assessment of FFPE tissue prior to molecular testing; typically billed separately from the molecular test.
`G9999`	Placeholder for payer-specific molecular billing instructions	Some payors use local or HCPCS-level guidance for billing proprietary tests; inclusion here represents administrative steps adjacent to `0498U`.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑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…
53	Modifier 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…
99	Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…	- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…
73	Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…	- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RG0100X	Gastroenterology Physician	An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This…
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
291900000X	Military Clinical Medical Laboratory	A Department of Defense (DoD) medical clinical reference laboratory not associated with a DoD Hospital or DoD Clinic. An example is the Armed Forces I…
163WP0218X	Pediatric Oncology Registered Nurse	Nursing Service Providers · Registered Nurse
344600000X	Taxi	A land commercial vehicle used for the transporting of persons in non-emergency situations. The vehicle meets local, county or state regulations set f…
364SL0600X	Long-Term Care Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist

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

Frequently Asked Questions

References

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.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.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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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81479`	Unlisted molecular pathology procedure	Used when a specific proprietary PLA code is not available; for `0498U` the PLA code is reported instead of `81479`.
`88184`	Interpretation of molecular cytogenetic or molecular pathology test results (may be used for separate professional component reporting in some payor policies)	May be reported by the pathologist or molecular geneticist when separate interpretive services are billed; check payer rules for bundling with `0498U`.
`36415`	Collection of venous blood by venipuncture	Used when a peripheral blood specimen is collected for ctDNA analysis accompanying the `0498U` panel.
`88305`	Level III surgical pathology, gross and microscopic examination	Used when pathologist performs initial histopathology assessment of FFPE tissue prior to molecular testing; typically billed separately from the molecular test.
`G9999`	Placeholder for payer-specific molecular billing instructions	Some payors use local or HCPCS-level guidance for billing proprietary tests; inclusion here represents administrative steps adjacent to `0498U`.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑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…
53	Modifier 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…
99	Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…	- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…
73	Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…	- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RG0100X	Gastroenterology Physician	An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This…
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
363L00000X	Nurse Practitioner	(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
291900000X	Military Clinical Medical Laboratory	A Department of Defense (DoD) medical clinical reference laboratory not associated with a DoD Hospital or DoD Clinic. An example is the Armed Forces I…
163WP0218X	Pediatric Oncology Registered Nurse	Nursing Service Providers · Registered Nurse
344600000X	Taxi	A land commercial vehicle used for the transporting of persons in non-emergency situations. The vehicle meets local, county or state regulations set f…
364SL0600X	Long-Term Care Clinical Nurse Specialist	Physician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist

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

Frequently Asked Questions

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 0498U: OptiSeq Colorectal Cancer NGS Panel

Sign up for cpt 0498U policy alerts

OpenPayer

CPT 0498U: OptiSeq Colorectal Cancer NGS Panel

Sign up for cpt 0498U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

CPT 0498U: OptiSeq Colorectal Cancer NGS Panel

Sign up for cpt 0498U policy alerts

CPT 0498U: OptiSeq Colorectal Cancer NGS Panel

Sign up for cpt 0498U policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does CPT code 0498U represent?

What specimen types and laboratory steps are involved for the OptiSeq panel?

Which other CPT codes might be reported alongside or instead of 0498U?

For which diagnoses or clinical uses is 0498U typically indicated?

Which payers are listed as covering the OptiSeq (0498U) test and does the page give reimbursement details?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does CPT code 0498U represent?

What specimen types and laboratory steps are involved for the OptiSeq panel?

Which other CPT codes might be reported alongside or instead of 0498U?

For which diagnoses or clinical uses is 0498U typically indicated?

Which payers are listed as covering the OptiSeq (0498U) test and does the page give reimbursement details?

References