Monday, June 29, 2020

Very Brief Blog: AMA Publishes Rapid Off-Cycle COVID PLA Codes (Qiagen, Mt Sinai)

Normally, AMA CPT releases new PLA codes exactly on a quarterly basis - around January 1, April 1, July 1, and October 1.   Each release is a set of codes applied-for one quarter prior (e.g. applied-for October 1, for release January 1).

AMA makes exceptions for PLA COVID codes.   

On May 25, 2020, AMA released code 0202U, for Biomerieux Respiratory Panel "plus one" - plus COVID (22 targets).  0202U was published and effective the same day, per AMA.

On June 25, 2020, AMA released two more urgent COVID codes, 0223U for Qiagen COVID, a viral panel with 22 targets, and 0224U for a Mt Sinai COVID single pathogen test.  I assume both have FDA EUA status.    0223U and 0224U were also published and effective the same day.

The online PDF at AMA with the newest codes is here.

Because PLA codes have formulaic rules of construction, the Biofire and Qiagen panels have exactly the same PLA code text, see picture below.  You have to look to an appendix to learn which code (0222U, 0223U) is which test.

Note - Plus or minus July 1, AMA will also release a couple dozen PLA codes applied for on the regular schedule April 1, for release July 1.  These codes won't be a surprise, because CMS already includes them in the June 22 Clin Lab Fee Schedule annual new coding public comment meeting on pricing.   AMA could have released those June 25, since it was updating the PDF anyway, but it will release them a few days from now.