Monday, April 3, 2023

Very Brief Blog: AMA Releases New PLA Codes

AMA publishes the results of first quarter PLA applications.   The publication includes October and January PLA codes, which will also be part of this summer's pricing meeting.


The AMA CPT accepts "PLA" proprietary lab code applications on a quarterly basis (e.g., January 1, April 1) and announces new decisions every quarter (e.g., April 1, July 1).

On March 31, the AMA posted decisions regarding PLA applications submitted in early January, which were voted on during the February AMA CPT meeting. In addition to several code deletions, new codes range from 0387U to 0401U, totaling 15 codes.

This publication is particularly useful as it compiles all the codes submitted too late for inclusion in the AMA CPT 2023 fall edition. Essentially, these codes will be discussed in this summer's CMS pricing meetings, as they missed the previous summer's session. The only remaining PLA codes to be added are those that will be submitted on April 6. The AMA is expected to finalize this batch of codes in early May, which should make them eligible for consideration during the CMS lab pricing meetings in June and July.

Here's the link to the new PLA codes:

Some Noteworthy Codes

This selection highlights a few noteworthy codes, with apologies to the many codes I'm not highlighting. See the full PDF above.

Kiyatec removes two codes for in vitro cancer cell analysis, Fujirebio introduces an FDA-approved Alzheimer's CSF test (0358U), and Mayo presents a neurofilament plasma test (0361U). 

Additionally, Biodesix obtains a code for its Nodify test (0360U), Adaptive Biotech acquires a ClonoSEQ code (0364U), and Diacarta introduces several proteomic bladder cancer tests. 

Thermo Fisher secures codes for four pathogen assay tests (0369U, 0370U, 0373U, 0374U), while Aspira codes OvaWatch (0375U) and Quest receives a tumor panel code (0379U).

New codes this week include Inivata's lung liquid biopsy (0388U), Strata's comprehensive tumor panel (0391U), Amprion's unique a-synuclein folding assay (0393U), Micronoma's OncobiotaLUNG for nodule-positive patients (0395U), and Agilent's ctDx FIRST for NSCLC (0397U) .  

Finally, there's Capsulomics/Previse's EsoPredict (0398U), which is in a clinical area I just discussed in light of a new LCD from MolDx.