CPT 0560U: Haystack MRD™ Baseline Genomic Variant Panel

CPT code 0560U designates the Haystack MRD™ Baseline test from Quest Diagnostics®, a Proprietary Laboratory Analyses (PLA) code for a personalized genomic sequencing panel derived from tumor tissue and whole blood. The assay establishes a patient-specific variant panel to detect minimal residual disease (MRD) and to serve as a baseline for serial MRD monitoring. Nationally, PLA codes like 0560U matter because they identify single-source, manufacturer- or lab-specific tests that can have distinct coverage and pricing considerations compared with nonproprietary assays.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. The report outlines which payers are evaluated and summarizes common coverage considerations for proprietary MRD assays.

Readers will learn the clinical purpose of the test, typical sites of service, and the context in which 0560U is reported. The publication provides benchmarks and policy-relevant information about proprietary genomic MRD testing, including payer coverage patterns, documentation expectations, and coding practice considerations. Data not available in the input will be identified as such in the detailed sections.

Billing Code Overview

CPT code 0560U is a Proprietary Laboratory Analyses (PLA) code that applies exclusively to the Haystack MRD™ Baseline test from Quest Diagnostics®. The test uses genomic sequence analysis of tumor tissue and whole blood to create a personalized variant panel that serves as a baseline for future minimal residual disease (MRD) assessments. The panel is designed to detect small amounts of cancer cells remaining after treatment by identifying patient-specific variants.

Service Type: Proprietary laboratory genomic sequencing for MRD baseline panel

Typical Site of Service: Clinical laboratory or reference diagnostic laboratory (Quest Diagnostics® testing facilities)

Clinical Context

A typical patient is an adult or pediatric oncology patient who has completed definitive therapy (surgery, chemotherapy, and/or radiotherapy) for a solid tumor or hematologic malignancy and requires a personalized baseline for future minimal residual disease (MRD) monitoring. The treating oncologist at an outpatient cancer center orders Haystack MRD™ Baseline to create a tumor-informed variant panel by combining genomic sequencing of available tumor tissue and matched whole blood. The specimen workflow includes: tumor tissue retrieval (archival fixed tissue or fresh biopsy) and a peripheral whole-blood draw; specimens are sent to Quest Diagnostics®; the laboratory performs genomic sequence analysis to identify tumor-specific variants and constructs a personalized assay for serial circulating tumor DNA (ctDNA) MRD surveillance. Typical sites of service include outpatient oncology clinics, hospital outpatient departments, and specialized molecular diagnostic laboratories. Results are used by the oncology care team to establish a individualized MRD baseline for subsequent surveillance testing and to inform clinical discussions about recurrence risk and surveillance intervals.

Coding Specifications

Modifier	Description	When to Use
`00`	Default/No modifier	Used when no additional circumstances apply to the service.
`22`

Taxonomy Code	Specialty	Notes
`207RH0000X`	Hematology & Oncology	Medical oncologists order MRD baseline testing for systemic malignancies and surveillance planning.
`207VG0400X`	Medical Genetics	Molecular geneticists and genomic medicine specialists may interpret complex genomic results and contribute to assay selection.
`2085P0202X`	Pathology - Anatomic & Clinical	Pathologists coordinate tumor tissue procurement and ensure appropriate specimen handling for genomic analysis.
`363L00000X`	Laboratory - Molecular Pathology	Clinical molecular diagnostic laboratories perform sequencing, bioinformatics, and assay design for MRD panels.
`207K00000X`	Internal Medicine	Hospital-based internists and oncology hospitalists may order baseline MRD testing during inpatient cancer care transitions.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C80.1`	Malignant (primary) neoplasm, unspecified	Used when a specific primary site is not documented but MRD baseline testing is indicated for cancer surveillance.
`C78.7`	Secondary malignant neoplasm of liver and intrahepatic bile duct	Common metastatic site where tumor tissue may be available for sequencing to generate an MRD panel.
`C50.9`	Malignant neoplasm of breast, unspecified	Breast cancer patients often undergo tumor-informed MRD testing for post-treatment surveillance planning.
`C34.90`	Malignant neoplasm of unspecified part of bronchus or lung	Lung cancer patients may have tumor tissue profiled for personalized MRD baseline development.
`C83.90`	Non-Hodgkin lymphoma, unspecified, not having achieved remission	Hematologic malignancies are frequent indications for MRD assays to monitor residual disease after therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0560U`	Haystack MRD™ Baseline — genomic sequence analysis of tumor tissue and whole blood to create a personalized variant panel for MRD detection	Primary PLA code to report this specific baseline MRD assay performed by Quest Diagnostics®.
`88184`	Morphometric analysis, quantitative; manual or computer-assisted (e.g., immunohistochemistry image analysis)	May be performed on tumor tissue to quantify tumor content prior to sequencing and to support adequacy of the tissue specimen used for panel design.
`88360`	Surgical pathology, gross and microscopic examination with consultation for complex cases (example; consultative interpretation)	Pathology review codes applicable when pathologist performs detailed review or consultation on tumor tissue selection and adequacy for molecular testing.
`81225`	EGFR (epidermal growth factor receptor) gene analysis, common variants (example somatic testing)	Representative molecular diagnostic code for targeted tumor variant testing that may be relevant in tumor profiling workflows feeding into MRD panel design.
`81455`	Cancer panel sequencing with interpretation, molecular oncology	General panel-based NGS testing code that represents broad genomic profiling often performed in parallel or prior to creation of personalized MRD assays.

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Summary & Overview