Thursday, October 13, 2022

Brief Blog: AMA Releases Bonanza of 35 PLA Applications

The AMA CPT has released for comment some 35 code actions for the October or Fourth Quarter PLA cycle.  A few of the applications are withdrawals or revisions, but most are for new PLA codes.

Find the AMA PLA home page here:

Find the AMA PLA PDF of the new action items here:

Comments on the PLA applications are offered only for a few days; see the PLA PDF for "Zendesk" instructions but do this right now if you want to comment on a code.

The PLA committee will meet and vote around November 7.   The AMA CPT committee will convene (quite briefly) by teleconference on November 21 to endorse the codes, so they can be released January 1.

Codes - A Few Highlights

It looks like the first agenda item is a PLA code for the Adaptive Biotechnologies FDA-approved CLONOSEQ test.

Two codes that just became active in July (0324U, 0325U) for cell culture drug response in oncology, are poised for deletion.  CMS had proposed to crosswalk these to the (I believe) off market Predictive Therapeutics cell culture codes from around 2014 (81535, 81536x3, $1100) whereas a near-identical test 0248U is in current gapfill at about $2600.

There is a code triplet for Oncuria (bladder cancer detection) and one for OVAWatch (ovarian cancer detection).   

There is a 17-pathogen bladder pathogen test (Qlear Urine), and a reflex version including antibiotic resistance genes.  There is a different test for "20 or more" pathogens in urine.  There is a 55-pathogen respiratory test. A separate wound infection test has 34 pathogens and 21 antibiotic resistance genes.  There are two complex kidney function tests (NaviDKD and PromarkerD).

There is the ArteraAI 128-image prostate image test with AI.

There is a somewhat complex (15 gene) cfDNA test for colorectal cancer.

Genesys has a 143-gene carrier panel.