Monday, January 4, 2021

Very Brief Blog: AMA releases January 1, 2021 PLA Codes

AMA releases new batches of Proprietary Laboratory Analysis codes every quarter.   The new batch for January 1, 2021 is out.  Codes released this week will be effective in one quarter (April 1, 2021) except for COVID-related codes, which AMA releases as "effective immediately" on a rolling basis.

See the home page for PLA codes here:

See the codes here:

Note that AMA accumulates PLA codes on a rolling basis quarter to quarter, but then cuts this online PDF list back each January, when codes from several previous quarters are officially published in the annual CPT handbook.

Upcoming PLA submission dates are January 7 and April 8.  April 8 submissions will probably be included in the June 2021 CMS annual new test pricing process.

By my count there were about 12 PLA codes released October 1, and only 6 released now for January 1.

The six new PLA codes are,

  1. 0242U, Guardant 360 CDx (FDA-approved LBx test)
  2. 0243U, Perkin Elmer pre-eclampsia biochemical assay
  3. 0244U, Paradigm Diagnostics, MAP Pan Cancer tissue test, 257 genes
  4. 0245U, Interpace Diagnostics, ThyGeNEXT thyroid oncogenes, 47 genes (fusions), includes risk of malignancy
  5. 0246U, San Diego Blood Bank, PrecisionBlood, 51 RBC antigens
  6. 0247U, Sera Prognostics, preterm birth biochemical assay (LCMS)
Regarding Sera PreTRM, see a January 2021 article about a real world study with Anthem, here.