Wednesday, March 3, 2021

Very Brief Blog: AMA Posts New Lab Code Proposals for May 2021 CPT Meeting

Every four months, AMA CPT holds an editorial panel meeting, and posts lab codes about 60 days in advance.  (Other codes are posted about 45 days in advance).

At the AMA website, here's how you find the lab test code agenda:

  • The main homepage for editorial panel postings is here.
    • AKA "About CPT Editorial Panel."
    • Scroll down this page, to find the recently-created posting for May 2021 meeting.
    • In the future, you'll scroll down this same page to find the future creations for the October 2021 meeting, the February 2022 meeting, and so on.
  • Find the May 2021 Editorial Panel homepage here.
    • Note that there is a link for free Registration (Don't wait to the last minute, registration will close).
  • Under AGENDA, find the lab codes public agenda.  AMA PDF cloud link here.

You can receive a summary of a particular lab CPT application, if you are a concerned stakeholder.  This is defined by AMA review, but it excludes e.g. consultants who are just curious about the code proposal.  See instructions on the PDF, including how to request a proposal by email and the requirement you explain your rationale for a request.  This moves fast - you must request a proposal (on which to comment) by March 15, and must submit a comment by March 22.   AMA would provide you with a structured comment template.

This cycle is the last cycle of new codes that will enter the CMS crosswalk/gapfill meeting in June 2021 and will be published in the AMA CPT annual book January 2022.

Code proposals for May 2021 include:
  • Hydroxychloroquine drug assay
  • Pancreatic elastase test, quantitative
  • Mitochondrial antibody
  • Voltage gated calcium channel antibody
  • Actin smooth muscle antibody
  • Antineutrophil ctoplasmic antibody
  • Blood culture, PCR multiplex panel, 26 or greater targets
    • Note: The code reference was initially mislabeled, AMA updated as 87X00..
  • Review 81228/81229 cytogenomics codes to better fit any future parent/child codes
  • Genomic sequencing procedure (GSP) for bone marrow failure (814XX)
  • Admin MAA A for renal allograft failure (CD154 memory cells)
  • Pedigree analysis for genetic risk (96X41, a 9---- series code, not 8--- series lab code)
  • Cytogenomic constitutional array by low pass NGS sequencing, 812X0
Regarding cytogenomic NGS sequencing.  In its recent going-public materials (page 23), Sema4 described clinical exome sequencing PLUS low pass NGS cytogenomic structure ("low pass genome") as a core test.   In addition, labs like Mayo, NY Genome Center and Perkin Elmer have gotten PLA codes for low-pass NGS cytogenomics (0012U, 0156U, 0209U), but there is no comparable non-branded CPT code.  

I noted this in a recent white paper about genomics and PLA codes (here). See e.g. Chau et al., 2020, Human Genetics 139:1403 (here), Chaubey et al. J Molec Dx 22:823 (here).  I discuss these further in a later blog - here.


Why are Lab codes posted earlier than other codes?

Lab codes are reviewed by at least one if not two workgroups AHEAD of the committee-of-the-whole meeting on May 6-8.   

Molecular codes are reviewed by a mopath workgroup (called MPAG) and then those codes and all lab codes are reviewed by the multi-stakeholder group Pathology Coding Caucus, convened by CAP and including members like AdvamedDx and ACLA, industry groups which do not otherwise have a seat at the table of the AMA's CPT.

Registering for the Meeting

From the May 2021 home page, there is a link to register.  This will trigger some follow up AMA DocuSign confidentiality documents then the AMA will send you a Zoom link for the May 6-8 meeting.

Next AMA CPT Meeting

The next CPT code application due date is June 30, for the September 30-Oct 2 CPT meeting.  Around 15-20 days after June 30, e.g. June 15-20, starting checking the About CPT home page for the creation of a new AMA webpage for the September 2021 meeting.  You may have to scroll downward a full screen or two.  When that September 2021 webpage is created, it will start containing links to preview the code agendas.  (See a screenshot of this process, here.)