Summary & Overview
CPT 0592U: Aventa Lymphoma NGS Panel, 417-Gene Targeted Assay
CPT code 0592U designates a Proprietary Laboratory Analyses (PLA) test for Aventa Lymphoma, a targeted next‑generation sequencing assay covering 417 lymphoma‑related genes. As a PLA code, 0592U applies exclusively to a single manufacturer’s or laboratory’s proprietary test, signaling a specific molecular diagnostic product rather than a family of assays. This type of code matters nationally as precision oncology testing grows: PLA codes clarify billing and identification for unique commercial assays used in diagnosis, prognosis, and therapeutic decision‑making for lymphoma patients.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical scope and service setting, plus benchmark and policy context for proprietary molecular testing: how PLA designation affects coding clarity, payer coverage considerations, and operational implications for laboratories and ordering clinicians. The publication also outlines common modifiers and notes where input data are not available. The goal is to give payers, laboratory billing staff, and policy analysts a clear, national‑level reference on the clinical purpose, billing identity, and payer landscape relevant to CPT code 0592U.
Billing Code Overview
CPT code 0592U is a Proprietary Laboratory Analyses (PLA) code specific to a single test: Aventa Lymphoma from Aventa Genomics LLC. The assay performs targeted next‑generation sequencing of 417 lymphoma‑related genes on DNA extracted from tumor sections, identifying point mutations and structural changes such as gene fusions and translocations.
Service type: Targeted next‑generation sequencing (molecular diagnostic assay)
Typical site of service: Clinical laboratory or reference molecular diagnostics laboratory
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a rapidly enlarging cervical lymph node and B symptoms (fever, night sweats, weight loss) undergoes excisional lymph node biopsy. Histopathology raises concern for a malignant lymphoma subtype. The treating hematologist-oncologist orders the proprietary genomic assay 0592U (Aventa Lymphoma by Aventa Genomics LLC) on formalin-fixed, paraffin-embedded tumor tissue to guide diagnosis and targeted therapy decisions. The clinical workflow includes: tissue procurement in the pathology suite, review and selection of representative tumor sections by a pathologist, DNA extraction and sample preparation in a molecular diagnostics laboratory, next-generation sequencing using a targeted 417-gene lymphoma panel, bioinformatic analysis to identify point mutations, copy number changes, and structural variants including gene fusions and translocations, and generation of a clinical report delivered to the ordering hematologist-oncologist and pathologist. Typical sites of service include hospital-based pathology/molecular laboratories, independent clinical laboratories, and specialty reference labs. Turnaround time is variable but generally ranges from days to a few weeks depending on test complexity and laboratory workflow. Common clinical uses include diagnostic clarification of lymphoma subtype, identification of actionable genomic alterations for therapy selection or clinical trial eligibility, and prognostic stratification.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No specific modifier; code reported without modifier | When no modifier is required or applicable for the service |
22 | Increased procedural services | When reporting increased complexity or work beyond the usual for the assay (documented justification) |
52 | Reduced services | When testing is partially reduced or limited compared with the full assay protocol |
53 | Discontinued procedure | When specimen or testing is begun but discontinued for patient- or specimen-related reasons |
26 | Professional component | When only the professional interpretation component is billed separately (if applicable in split billing arrangements) |
TC | Technical component | When only the technical laboratory component is billed (sequencing and analysis) |
59 | Distinct procedural service | When a separate and distinct laboratory service is provided on the same date that is not bundled with 0592U |
90 | Reference (outside) laboratory | When testing is sent to an outside reference laboratory for performance of the assay |
91 | Repeat clinical diagnostic laboratory test | When the identical assay is repeated on the same specimen to confirm results |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RH0000X | Hematology & Oncology | Ordering clinicians who manage lymphoma diagnosis and treatment |
| 207K00000X | Hematopathology | Pathologists specializing in hematologic malignancies who select tissue and interpret results |
| 208000000X | Anatomic Pathology | Pathologists involved in tissue acquisition and processing |
| 353L00000X | Molecular Diagnostic Laboratory | Laboratory directors and molecular pathologists overseeing NGS testing |
| 261QM0400X | Oncology Nurse Practitioner | Advanced practice clinicians coordinating test ordering and follow-up |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C82.90 | Follicular lymphoma, unspecified site, unspecified | Follicular lymphoma subtyping and mutational profiling can guide prognosis and therapy selection using 0592U |
C83.30 | Large B-cell lymphoma, unspecified site | Diffuse large B-cell lymphoma evaluation for actionable mutations and translocations is a common indication for comprehensive NGS panels |
C85.80 | Other specified types of non-Hodgkin lymphoma | Used when uncommon lymphoma subtypes require broad genomic characterization to clarify diagnosis and therapeutic options |
C81.90 | Hodgkin lymphoma, unspecified, site unspecified | In select diagnostic dilemmas, molecular profiling may assist in distinguishing Hodgkin lymphoma from other entities |
R59.0 | Localized enlarged lymph nodes | Unexplained lymphadenopathy prompting biopsy and subsequent molecular lymphoma testing with 0592U |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
88305 | Level IV surgical pathology, gross and microscopic examination | Tissue evaluation and diagnosis that often precedes molecular testing and selection of blocks for 0592U |
88112 | Cytopathology, cell block preparations or special stains (per specimen) | Ancillary specimen preparation when cytology specimens are used to create cell blocks for molecular testing |
81225 | EGFR (epidermal growth factor receptor) gene analysis; full sequence analysis | Example of other molecular gene testing; performed in parallel for targeted therapy panels when relevant (not specific to lymphoma) |
81479 | Unlisted molecular pathology procedure | Used when a specific molecular test lacks an exact CPT match; historically used before PLA codes like 0592U were available |
0000U | Data not available in the input. | Data not available in the input. |