CCSD code 0006G: KRAS mutation analysis

Key Takeaways

CCSD code 0006G is the UK private healthcare diagnostic (pathology) code for KRAS mutation analysis, listed in Chapter 34 (Pathology) of the CCSD schedule maintained by the Clinical Coding and Schedule Development (CCSD) Group.

0006G replaces the retired code 7900T. Bill the current code, and confirm its narrative in the authenticated CCSD schedule at ccsd.org.uk or the Bupa code search portal before you submit.

Major UK insurers including Bupa, AXA Health, Aviva, Vitality, and Allianz Care recognise CCSD codes as the billing standard, but pre-authorisation rules and reimbursement rates vary by insurer.

Pabau’s claims management software supports structured documentation and audit-ready record-keeping for UK private healthcare billing workflows.

CCSD code 0006G is the code UK private medical insurers recognise for KRAS mutation analysis, a molecular pathology test that checks a tumour sample for mutations in the KRAS gene. Because KRAS status shapes targeted-treatment decisions in cancers such as colorectal and non-small cell lung cancer, the test is usually requested by an oncologist and reported by a pathology laboratory. The code sits in Chapter 34 (Pathology) of the CCSD schedule and replaces the retired code 7900T. This guide covers how to verify the code, document it, and get it paid across the major UK insurers.

CCSD code 0006G: definition, schedule position, and clinical scope

CCSD code 0006G identifies KRAS mutation analysis within the Clinical Coding and Schedule Development (CCSD) schedule, the standard code set used across UK private healthcare for consistent clinical activity coding. It is a diagnostic pathology code, not a surgical procedure code, so it belongs on the diagnostic line of an invoice rather than the procedures line.

The CCSD schedule is updated periodically, so confirm the current narrative for 0006G against the authenticated schedule before you submit. Two details matter most at the point of billing: the code covers KRAS mutation analysis on a tumour sample, and it replaces the older code 7900T, which should no longer be submitted.

Schedule chapter classification

0006G sits in Chapter 34 (Pathology) of the CCSD diagnostic schedule, within the molecular and genetic testing group (category 34.1). Practitioners moving from NHS to private practice often meet this diagnostic-schedule structure for the first time and misclassify the submission type as a result.

The practical implication is straightforward. KRAS mutation analysis is a diagnostic charge, so 0006G belongs under the diagnostic section of your invoice, and the fee is the pathology test itself, not a procedure fee. Submitting a pathology code under a procedures line, or billing the retired 7900T, is a common source of query letters from payer billing teams.

Who requests CCSD code 0006G and in what clinical settings

KRAS mutation analysis is ordered when a patient’s cancer treatment depends on the tumour’s genetic profile. In private practice, the request usually comes from a medical or clinical oncologist and the analysis is run by a molecular pathology laboratory, with the result reported back to the requesting consultant.

That referral chain is why 0006G rarely appears on an invoice in isolation. It typically follows a consultation and a tissue sample, and more than one provider may bill for the same episode of care. Getting the code, the requesting clinician, and the report aligned before submission is what keeps the claim moving.

Documentation requirements for CCSD code 0006G

Insurers routinely audit pathology and genetic-test claims. A claim that cannot be matched to supporting clinical documentation at the point of query will either be delayed or rejected outright. Getting the documentation right before submission, not after a denial, is far more efficient.

The following records are expected for a KRAS mutation analysis claim across the major UK private medical insurers. Store these in a digital clinical forms system so they can be retrieved quickly on request:

• Clinical indication: the reason the test was clinically necessary, tied to the patient’s cancer type or presenting condition, not a generic request.
• Consent record: written consent from the patient, dated on or before the date of service.
• Pathology report: a contemporaneous report signed by the responsible clinician, stating the gene tested and the result.
• Pre-authorisation reference number: where the insurer required prior approval, the authorisation number must appear on the invoice. A claim submitted without this reference will be rejected at triage.
• Referring clinician details: most insurers require the name and GMC or NMC number of the requesting practitioner for diagnostic tests.

UK private practices also have obligations under data protection law when storing and handling clinical records. A GDPR compliance checklist for healthcare settings covers the key retention and access requirements your practice needs to maintain alongside billing documentation.

Documentation anti-patterns that trigger audits

Three documentation problems generate the majority of insurer audit letters for diagnostic-test claims. The first is a clinical indication that is too vague, such as “patient requested test,” which does not satisfy medical necessity standards. The second is a missing or undated consent record. The third is a report that gives only a result without naming the gene tested or the method used. Each of these can be addressed at the point of care with structured note templates rather than retrospectively.

Insurer-specific rules: Bupa, AXA Health, Aviva, Vitality, and Allianz Care

No two insurers handle CCSD diagnostic claims identically. Fee levels, pre-authorisation thresholds, and invoice format requirements differ. The table below summarises the key policy positions that affect how you submit CCSD code 0006G claims to each major insurer. Always verify current rules directly with each payer, as fee schedules and approval thresholds are updated periodically.

For Bupa specifically, the Bupa CCSD codes guide on Pabau explains how to use the Bupa Code Search portal to confirm whether a code is covered under a patient’s policy before the appointment. This step alone prevents a significant share of post-service denials.

Bupa CCSD codes: code search and fee confirmation

Bupa uses its own code search portal to confirm which CCSD codes it recognises and at what fee level. Before billing CCSD code 0006G to Bupa, search the code in its own code search portal to verify it returns a recognised fee. Bupa uses CCSD as the industry standard for clinical activity coding. If the code does not appear, contact the Bupa provider helpline before submitting.

AXA Health: fee chapter alignment

AXA Health organises its codes by fee chapter. When submitting a diagnostic code, confirm which chapter your service falls into via the AXA specialist procedure codes portal. Mismatched chapter assignments are a leading cause of query letters from AXA. Your compliance management tools should flag chapter mismatches before an invoice is finalised.

Vitality: fee finder and coverage verification

Vitality Health operates a fee finder tool that lets providers look up the benefit amount Vitality will pay for a specific CCSD code under a patient’s policy. Run this check before the consultation to set correct patient expectations about any shortfall. Vitality requires pre-authorisation for most diagnostic tests, and the authorisation reference must appear on the invoice.

Allianz Care: diagnostic test coverage

The Allianz Care UK fee schedule sets out the codes it recognises and the fees it pays. Confirm that 0006G is listed and covered under the patient’s plan before you submit, as coverage for molecular and genetic tests can differ from plan to plan. Where a test is not listed, contact Allianz Care before invoicing rather than assuming the fee.

Pre-authorisation process for CCSD code 0006G

Pre-authorisation is expected for diagnostic and genetic tests with the major UK private medical insurers. Submitting a claim without a valid authorisation number is the fastest route to a rejected invoice. The process varies slightly by insurer but follows the same general sequence across Bupa, AXA Health, Aviva, Vitality, and Allianz Care.

1. Confirm coverage before the appointment. Ask the patient to confirm with their insurer that CCSD code 0006G is covered under their policy. The patient, or the practice on their behalf, obtains a provisional authorisation number and a confirmed benefit amount.
2. Record the authorisation number. Store the pre-authorisation reference in the patient record when it is received. Systems with structured client record management can attach this reference directly to the appointment, making it retrievable at the point of invoicing.
3. Submit the claim with the reference on the invoice. Every invoice line for CCSD code 0006G must carry the authorisation number. Insurers match claims to authorisations at processing, and a missing reference fails the match automatically.
4. Meet the submission deadline. Most major insurers impose a time limit on claim submission after the date of service, typically three to six months. Claims submitted outside this window are rejected regardless of clinical validity.
5. Respond to queries promptly. Insurers may request supporting documentation after an initial submission. Practices using claims management software can track open queries against each claim and set response reminders.

Related CCSD codes and cross-coding considerations

KRAS mutation analysis rarely appears in isolation on a claim. Understanding the codes that commonly accompany CCSD code 0006G prevents both under-coding, which leaves reimbursable items off the invoice, and over-coding, which bills a bundled item twice. The CCSD Technical Guide sets out the business rules that govern code combinations, so check it for the specific codes you intend to submit together.

Practices that regularly bill combinations of pathology codes benefit from a structured invoice review process. The compliance documentation requirements for UK private clinics include record-keeping obligations that apply equally to combination claims as to single-code invoices.

Common claim errors for CCSD code 0006G

Claims for KRAS mutation analysis fail for predictable, preventable reasons. The private healthcare referral pathway adds complexity, because a single episode of care may involve an oncologist, a pathology laboratory, and separate invoices, and coordination errors compound quickly. These are the most common failure patterns.

Missing or invalid pre-authorisation reference

This accounts for a disproportionate share of first-pass rejections. The fix is process-level: build a check that no invoice is finalised without a recorded authorisation number. Some practices designate a billing coordinator to confirm the reference is present before the invoice leaves the practice.

Submitting under the wrong schedule or a retired code

Billing a diagnostic pathology code under the procedures section, or submitting the retired 7900T instead of 0006G, is detected at insurer processing and generates a query. Practices new to CCSD billing, including those building efficient private practice workflows, often encounter this on their first few diagnostic invoices. The CCSD schedule is the definitive source for the current code and its chapter.

Duplicate billing within a molecular panel

When KRAS analysis is included in a broader molecular panel that carries its own code, billing both the panel and 0006G overstates the claim and triggers audit flags. The reverse error, splitting out a marker that should sit inside a panel, can under-code the claim. Both are avoidable by checking the CCSD business rules for the specific combination before submission.

Late submission

Every insurer imposes a submission deadline measured from the date of service, most often three to six months. A claim that is clinically valid and fully documented will still be rejected if it arrives outside the window. Tracking open invoices against their service dates and deadlines is a core function of a billing workflow; the CQC’s role in private healthcare governance also covers record-keeping standards that relate to timely billing documentation.

Insufficient clinical documentation

A claim that passes initial processing may still be queried at audit if the supporting clinical record is thin. Insurers increasingly request documentation as part of post-payment review programmes. Maintaining a complete, contemporaneous record for every CCSD code 0006G service, stored where it can be retrieved quickly, is the most effective defence against retrospective audit challenges.

How to submit CCSD code 0006G claims via Healthcode

Healthcode is the primary electronic data interchange platform for UK private healthcare claims. Most major insurers, including Bupa, AXA Health, Aviva, Vitality, and Allianz Care, accept electronic submissions via Healthcode. Paper-based submission is still accepted by some insurers but increases processing times and error rates.

A standard Healthcode submission for CCSD code 0006G requires the following data fields to be complete and accurate:

• CCSD code: 0006G, entered exactly as it appears in the CCSD schedule.
• Diagnostic description: the standard CCSD narrative for the code, not a free-text substitute.
• Date of service: matching the clinical record exactly.
• Pre-authorisation number: from the insurer, matching the policy and member details.
• Practitioner details: the GMC or NMC number of the requesting clinician.
• Practice code: the insurer-assigned provider number for your practice.
• Fee charged: must not exceed the insurer’s recognised fee for 0006G without prior agreement.

Practices managing a high volume of CCSD claims benefit from integrating their practice management system with Healthcode directly. This removes manual re-keying of data between clinical records and claim submissions, which is where transcription errors most commonly occur. The GDPR compliance checklist for UK practices also covers the data transfer obligations that apply when patient data moves between a practice system and Healthcode.

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Conclusion

Claim rejections on CCSD code 0006G are rarely caused by the clinical work being wrong. They are caused by process problems: a missing authorisation number, a diagnostic code billed as a procedure, the retired 7900T submitted by mistake, or documentation that cannot support a post-payment audit. Fix the process and the KRAS mutation analysis claim usually pays on first pass.

Pabau’s claims management software helps UK private practices track authorisation status, attach clinical documentation to each claim, and meet insurer submission deadlines without manual chasing. If your team is spending time correcting avoidable diagnostic-code denials, book a demo to see how Pabau handles the billing workflow end to end.

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