How To Use CPT Code 0173U

CPT 0173U describes a specific genomic analysis panel test called the Psych HealthPGx Panel. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0173U.

1. What is CPT Code 0173U?

CPT 0173U can be used to report the Psych HealthPGx Panel test from RPRD Diagnostics. This test evaluates gene sequence variants of 14 genes to provide information for making decisions about appropriate psychiatric therapies. It is a proprietary laboratory analysis (PLA) code, meaning it applies to a unique lab test performed by a specific lab or manufacturer.

2. Official Description

The official description of CPT code 0173U is: ‘Psychiatry (i.e., depression, anxiety), genomic analysis panel, includes variant analysis of 14 genes.’

3. Procedure

1. The lab analyst performs the technical steps required for the Psych HealthPGx Panel test using a patient specimen, such as blood.
2. The test identifies genetic variations in 14 genes, including those involved in the formation or breakdown of certain molecules inside cells.
3. Mutations in these genes can impact the breakdown of medications, affecting drug efficacy and toxicity.

4. Qualifying circumstances

CPT code 0173U is appropriate for patients diagnosed with psychological disorders such as depression, anxiety, and others. Clinicians may order this test to help with personalized drug recommendations and avoidance of adverse drug reactions for the patient.

5. When to use CPT code 0173U

CPT code 0173U should be used when reporting the Psych HealthPGx Panel test from RPRD Diagnostics. It should not be reported using any other CPT code. This code is specific to the unique test provided by the lab or manufacturer.

6. Documentation requirements

To support a claim for CPT code 0173U, the documentation should include:

• Patient’s diagnosis of a psychological disorder
• Specific details about the test performed, including the genes analyzed
• Date of service and the specimen analyzed

7. Billing guidelines

When billing for CPT code 0173U, ensure that the test is performed by the specific lab or manufacturer associated with this code. It is important to report one unit of this code for a single specimen analyzed on a single date of service. Some payers may separately reimburse for specimen collection using a code such as 36415.

8. Historical information

CPT code 0173U was added to the Current Procedural Terminology system on July 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A clinician orders the Psych HealthPGx Panel test for a patient diagnosed with depression to determine personalized drug recommendations.
2. A psychiatrist utilizes the Psych HealthPGx Panel test to identify genetic variations in 14 genes for a patient with anxiety, aiding in the selection of appropriate psychiatric therapies.
3. A mental health provider orders the Psych HealthPGx Panel test for a patient with bipolar disorder to help avoid adverse drug reactions and optimize medication efficacy.
4. A primary care physician utilizes the Psych HealthPGx Panel test for a patient with schizophrenia to inform decisions about appropriate psychiatric medications.
5. A psychologist orders the Psych HealthPGx Panel test for a patient diagnosed with post-traumatic stress disorder to assist in personalized drug recommendations and minimize adverse drug reactions.
6. A psychiatrist utilizes the Psych HealthPGx Panel test for a patient with obsessive-compulsive disorder to guide medication selection and dosage adjustments.
7. A mental health provider orders the Psych HealthPGx Panel test for a patient with attention-deficit/hyperactivity disorder to optimize medication choices and minimize side effects.
8. A clinician utilizes the Psych HealthPGx Panel test for a patient with eating disorders to aid in personalized drug recommendations and minimize adverse drug reactions.
9. A psychiatrist orders the Psych HealthPGx Panel test for a patient with substance use disorder to guide medication choices and minimize potential drug interactions.
10. A mental health provider utilizes the Psych HealthPGx Panel test for a patient with autism spectrum disorder to inform decisions about appropriate psychiatric therapies.