Thursday, July 2, 2020

AMA Updates its PLA Code List for July 1: Reaches PLA Code #224

AMA publishes PLA codes in its annual codebook, and all codes that are more recent than the published codes, appear on a PDF on the AMA website which is updated quarterly.

On June 25, 2020, AMA released some off-cycle "stat" CPT codes for a couple new COVID PLA tests.

On July 1, 2020, AMA released the full set of new PLA codes for July 1.

The code list is online  here.   Because the 2020 code book runs to 0138U, most of the codes published in the online AMA PDF are from 0139U forward.   However, some earlier codes appear as well, due to the actions of deletion or revision. 

The new PLA codes run from 0202U to 0224U.   Generally, these are "published July 1 and effective October 1."  However, COVID PLA codes (for example, 0223U, Qiagen) are effective on the same day the AMA publishes them.

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The codes published by AMA on July 1 were transmitted to CMS by around June 1 and included in the current summer CLFS pricing process at CMS.  This year, CMS broadcast the CLFS public meeting as a webinar rather than via YouTube streaming, and the webinar so far has NOT been video archived at the CMS YouTube channel.  However, I provided an unofficial transcript at the link just given.

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Figure below: Note that most PLA codes are published July 1, effective October 1, but the lower two codes, the COVID codes, are published off-cycle ASAP and effective immediately when published.