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 |