Summary & Overview
CPT 0573U: PanCystPro™ Pancreatic Cyst Biomarker Panel
CPT code 0573U designates Amplified Sciences PanCystPro™, a Proprietary Laboratory Analyses (PLA) test that evaluates pancreatic cyst fluid for glucose, carcinoembryonic antigen (CEA), and gastricsin and applies an algorithm to classify cysts as mucinous or nonmucinous. As a PLA code, 0573U is tied to a single manufacturer's proprietary test and is used to report that specific laboratory service. This test matters nationally because pancreatic cyst characterization can influence surveillance and management strategies, and algorithm-driven biomarker panels represent a growing area of diagnostic innovation.
Key payers included in the discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical purpose and service setting, plus context on payer coverage trends and typical billing considerations for proprietary laboratory tests. The publication summarizes benchmarking and reimbursement context where available, explains clinical relevance for pancreatic cyst evaluation, and flags policy developments relevant to PLA codes and laboratory reimbursement. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0573U is a Proprietary Laboratory Analyses (PLA) code that applies only to a single, specific laboratory test: Amplified Sciences PanCystPro™ from Amplified Sciences Inc. The test analyzes a fluid sample from a pancreatic cyst to measure three biomarkers — glucose, carcinoembryonic antigen (CEA), and gastricsin — and uses an algorithm to classify the cyst as mucinous or nonmucinous.
Service type: Laboratory diagnostic test (proprietary biomarker panel with algorithmic interpretation)
Typical site of service: Clinical laboratory or hospital outpatient laboratory using pancreatic cyst fluid collected during endoscopic or image-guided procedures
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with incidentally detected pancreatic cystic lesion on abdominal imaging is referred to a gastroenterologist for evaluation. Endoscopic ultrasound (EUS) with cyst fluid aspiration is performed to obtain fluid for diagnostic testing. The aspirated fluid is sent to the laboratory for the proprietary panel 0573U (Amplified Sciences PanCystPro™) which measures glucose, carcinoembryonic antigen (CEA), and gastricsin and applies an algorithm to classify the cyst as mucinous versus nonmucinous. Results are used alongside cytology, imaging characteristics, and clinical factors to guide surveillance versus therapeutic decisions. Typical site of service is an outpatient endoscopy or ambulatory surgical center where EUS-guided fine-needle aspiration is performed; the laboratory analysis occurs in a reference or proprietary lab affiliated with the test manufacturer.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When reporting increased complexity or work for the laboratory or specimen handling beyond typical processing for 0573U (supporting documentation required). |
52 | Reduced services | When the laboratory test is partially performed or truncated such that full testing algorithm cannot be completed.
53 | Discontinued procedure | When specimen collection or testing was started but discontinued for patient safety or specimen quality reasons prior to completion.
59 | Distinct procedural service | When another unrelated procedure or lab test is performed on the same date that must be reported separately from 0573U.
76 | Repeat procedure by same provider | When the same proprietary assay 0573U is repeated during the same encounter by the same performing lab.
77 | Repeat procedure by another provider | When 0573U is repeated and performed by a different laboratory.
90 | Reference (outside) laboratory | When 0573U is performed and billed through a reference lab distinct from the ordering facility.
91 | Repeat clinical diagnostic laboratory test | When an identical laboratory test (0573U) is repeated on the same day to confirm unexpected or discordant results.
96 | Habilitative services | Rarely used for diagnostic lab tests; not typically applicable but included for completeness when payer-specific rules require it for laboratory benefit classification.
QW | CLIA waived test | Not applicable to most PLA tests but used when a test meets CLIA waived criteria and billing requires the modifier.
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RH0000X | Gastroenterology | Endoscopists performing EUS and cyst aspiration. |
208000000X | General Surgery | Surgeons involved when operative management of pancreatic cysts is performed.
363L00000X | Clinical Laboratory | Laboratory directors and pathologists overseeing proprietary assay performance and reporting.
207K00000X | Gastrointestinal Surgery | Surgical subspecialists managing complex pancreatic disease.
2083P0001X | Diagnostic Radiology | Radiologists who interpret imaging leading to cyst detection and guide multidisciplinary care.
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
K86.2 | Cyst of pancreas | Direct indication for pancreatic cyst fluid analysis with 0573U to determine mucinous character. |
K86.3 | Pancreatic cyst, unspecified | Used when a pancreatic cyst is present and biomarker classification (0573U) is needed for management.
R93.0 | Abnormal finding on diagnostic imaging of other body structures | Reporting imaging abnormality that prompted EUS and cyst aspiration with 0573U.
R19.7 | Diarrhea, unspecified | Included when clinical gastrointestinal symptoms accompany pancreatic disease evaluation; may be part of differential workup.
Z86.010 | Personal history of malignant neoplasm of pancreas | Relevant when assessing cysts in patients with prior pancreatic malignancy where 0573U helps risk stratification.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
43238 | Endoscopic ultrasound, diagnostic, with or without FNA, esophagus, stomach, duodenum, biliary tract; with FNA and/or biopsy | EUS-FNA is the typical procedural method to obtain pancreatic cyst fluid specimen sent for 0573U. |
43999 | Unlisted procedure, stomach, esophagus and/or duodenum | Used in certain coding scenarios for atypical or novel procedural approaches to access pancreatic cysts when no specific code applies (facility-level reporting adjunct to 0573U).
81002 | Urinalysis without microscopy for non-automated test | Data not available in the input.
88305 | Level IV surgical pathology, gross and microscopic examination | Cytology or pathology evaluation of cyst fluid or cell block often performed alongside molecular or biomarker testing like 0573U.
88342 | Immunohistochemistry or special staining (each antibody) | Ancillary stains or immunohistochemistry performed on cyst fluid cell block when needed in parallel with biomarker testing.