Friday, September 30, 2016

AMA Loads Webpages for "PLA" Quarterly Lab Codes

PAMA, the laboratory pricing reform law, requires CMS to create rapid temporary codes (on external stakeholder request) for what PAMA defines as "advanced diagnostic laboratory tests," and also requires CMS to create "tracking codes" for FDA approved tests on request.

In June 2016 rulemaking, CMS announced it would accomplish both tasks by making quarterly "G" codes, unless AMA had already created a code.

For the past year, AMA has been discussing and refining how it could create quarterly lab test codes outside the regular CPT Category I system.   Now, CMS has posted webpages that describe the quarterly coding process for "PLA - Proprietary Laboratory Analyses."   PLA codes are deliberately easy to get - they are designed to be a "superset" of the codes CMS needs to implement for PAMA.

In brief, AMA will create the codes on a rapid quarterly basis, and CMS will have its own processes to determine what "is" an ADLT.

The AMA PLA Home Page is here.  See multiple links, such as application form and calendars.  Pay particular attention to the PLA FAQ here.

A 15 slide introductory deck on PAMA PLA is here.  The first deadline cycle will accept applications October 1-15, 2016, for a PLA committee meeting in mid November.