Summary & Overview
CPT 0517U: PrecisView® CNS Plasma Psychoactive Drug Panel
CPT code 0517U designates a Proprietary Laboratory Analyses (PLA) test — PrecisView® CNS from Phenomics Health™ Inc. — that uses LC–MS/MS to quantify 80+ psychoactive drugs in plasma and reports minimally and maximally effective dose ranges. As a PLA code, 0517U is specific to a single manufacturer's assay and is used when that unique test is performed.
Nationally, this code matters because it represents a growing class of high-complexity, manufacturer-specific laboratory services that support precision medication management for patients on complex psychotropic regimens. Payers in this analysis include Aetna, Blue Cross Blue Shield plans, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what the code represents, clinical context for use in medication management, and the payer landscape addressed in this publication. The content covers benchmarks for utilization and coverage policy trends for proprietary laboratory tests, common billing and modifier considerations, and implications for laboratory and clinical sites of service. Data limitations and unavailable fields are noted where input was not provided.
Billing Code Overview
CPT code 0517U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to the PrecisView® CNS test from Phenomics Health™ Inc. The test uses liquid chromatography–tandem mass spectrometry (LC–MS/MS) to analyze plasma and measure levels of 80 or more psychoactive drugs, reporting minimally and maximally effective dose estimates for prescribed and nonprescribed medications.
Service Type: Laboratory — Proprietary quantitative plasma drug analysis using LC–MS/MS
Typical Site of Service: Reference laboratory or specialized clinical laboratory
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient with treatment-resistant major depressive disorder and a complex history of multiple psychotropic medication trials is evaluated by a psychiatric clinic. The treating psychiatrist orders the PrecisView® CNS test (0517U) performed by Phenomics Health™ Inc. to quantify plasma concentrations of 80+ psychoactive drugs using liquid chromatography–tandem mass spectrometry (LC–MS/MS). The goal is to identify subtherapeutic, therapeutic, or supratherapeutic drug levels and detect unreported substances to inform medication optimization. Specimen collection occurs at an outpatient laboratory draw station or a hospital phlebotomy unit; the sample is shipped to the proprietary laboratory. Results are returned to the ordering clinician and reviewed during a follow-up visit to correlate measured concentrations with clinical response and adverse effects, guiding dose adjustments or medication changes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing separately for the physician interpretation or professional component of the test if applicable and reportable. |
52 | Reduced services | Use if the laboratory report or testing performed was incomplete or limited compared with full assay performance. |
53 | Discontinued procedure | Use when testing was discontinued prior to completion for patient or specimen-related reasons. |
62 | Two surgeons | Rarely applicable; use only if two providers share responsibility for interpretation per payer rules. |
78 | Unplanned return to the operating/procedure room | Generally not applicable but available if an unforeseen procedural event requires immediate re-collection in an inpatient setting. |
80 | Assistant surgeon | Use only if an assistant with a billable role participates in the collection or procedural aspect and payer allows. |
82 | Assistant surgeon (following waiver) | Use when an assistant surgeon is used and the payer has a waived requirement for a board-certified assistant. |
QK | Medical direction of two or more qualified individuals | Use if the ordering clinician medically directs multiple practitioners involved in specimen collection/interpretation per payer policy. |
QX | Modifier indicating separately payable assistant surgeon | Use when assistant services meet payer criteria for separate payment. |
TC | Technical component | Use if submitting only for the laboratory technical component (testing, reagents, instrumentation) when the laboratory separates TC/26. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2084P0800X | Psychiatry & Neurology | Psychiatrists commonly order 0517U for medication management and dosing optimization. |
| 207L00000X | Pathology & Clinical Laboratory | Laboratory directors and clinical chemists oversee LC–MS/MS testing and result validation. |
| 208000000X | Family Medicine | Primary care clinicians managing complex polypharmacy may order the test for therapeutic monitoring. |
| 207R00000X | Clinical Pharmacology | Clinical pharmacologists consult on interpretation of multi-drug plasma concentrations and pharmacokinetics. |
| 363A00000X | Phlebotomy Technician | Phlebotomy personnel perform specimen collection in outpatient or inpatient draw locations. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
F32.4 | Major depressive disorder, single episode, severe with psychotic features | Used when medication optimization and confirmation of therapeutic levels are needed in severe depression with complex pharmacotherapy. |
F33.2 | Major depressive disorder, recurrent severe without psychotic features | Used for recurrent, treatment-resistant depression where plasma drug levels guide regimen adjustments. |
F11.20 | Opioid dependence, uncomplicated | Relevant when monitoring for concurrent opioid use or unexpected opioid levels that affect psychotropic safety. |
F10.20 | Alcohol dependence, uncomplicated | Alcohol use affects psychotropic metabolism; testing may detect alcohol-related medications or interactions. |
F41.1 | Generalized anxiety disorder | Common indication where multiple anxiolytics or antidepressants are prescribed and therapeutic monitoring is useful. |
F11.10 | Opioid abuse, uncomplicated | Detecting nonprescribed opioids or variable levels can alter psychiatric medication choices. |
F15.10 | Other stimulant dependence, uncomplicated | Stimulant levels and co-ingested substances can impact psychiatric treatment planning. |
Z79.899 | Long term (current) use of other medications | Captures patients on chronic polypharmacy where periodic quantitative monitoring is indicated. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
81002 | Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, specific gravity, etc.; non-automated, without microscopy | May be performed at point-of-care to screen for substances or renal function prior to LC–MS/MS testing. |
36415 | Collection of venous blood by venipuncture | Venipuncture is the typical specimen collection procedure required to obtain plasma for 0517U testing. |
82746 | Phenobarbital; quantitative | Targeted quantitative drug assays (example) may be ordered alongside or prior to broad-panel LC–MS/MS for confirmation or historical comparison. |
80104 | Drug screen, qualitative; multiple drug classes by instrumented chemistry analyzers (e.g., immunoassay) | Initial qualitative toxicology screening may precede the more comprehensive quantitative 0517U panel. |
81479 | Unlisted molecular pathology procedure | Occasionally used for reporting novel or proprietary test-related billing when specific PLA codes are not applicable; not typically used with 0517U which is a PLA code. |