Wednesday, June 21, 2023

Exact Sciences Investor Day - Meanwhile at AMA, Cologuard Code Revision "Rejected"

Exact Sciences held its June investor day, covered in a number of news stories.  Here, here.  A new version of the Cologuard test had its data unwrapped, and should be on its way to FDA by end of year, for approval in 2024. And the age span for the trial, BLUE C, goes as young as 40.

Meanwhile, AMA CPT releases its editorial panel actions from May 2023.  Tab 19 was revision to the colon cancer test 81528 - meaning Cologuard.  The result is tersely described as: REJECTED.   (Had the revision been accepted, it could have showed up at this week's CLFS pricing meeting). 

Here's a screen shot:

click to enlarge

The CPT agenda lists 9 codes in a row for lab medicine, of which two were accepted (one a Hep D PCR, and one just an administrative MAAA code for a CV risk test).  The other 7 were mostly withdrawn, with two rejected.

At CPT in any healthcare field, codes that are likely to fail the vote are usually withdrawn (sort of like resigning in chess).  Separately from the 9 codes, over a dozen digital pathology Cat III codes were revised or created, and 18 PLA codes were created, plus 7 revised.  


Another take home lesson is that being a huge company doesn't mean you get what you ask for at AMA CPT.