Sunday, October 8, 2023

Brief Blog: AMA Publishes New October 2023 PLA Codes (Up to 0438U)

Every quarter, AMA accepts new PLA code applications, publishes the accepted ones 3 months later for an effective date 6 months after submission.  For example, July applications are published as final on October 1 and effective January 1.   

In addition, AMA continually updates an online PDF file with all PLA codes issued since the last AMA annual code book.   For us, the 2023 Code Book goes up to PLA 0354U, so the PDF running update starts with code 0355U.   This set runs up to 0438U, which will appear as effective 1/1/2024 in the 1/1/2024 codebook.  Correspondingly, I think the next AMA PDF listing of new PLA codes will start with 0439U on page 1, on January 1, 2024.

Sometime aroudn October 9-15, AMA will release the newly-submitted codes (of October 3 due date) for public comment.



Here's the PLA home page:

https://www.ama-assn.org/practice-management/cpt/cpt-pla-codes

And here's the most recent update:

https://www.ama-assn.org/system/files/cpt-pla-codes-long.pdf

AMA remarks that 2 codes were revised and 19 codes were new.

Newly released codes (October 1 annoucement, January 1 effective date) start with 0420U.   I provide very brief summaries of the new codes here, for full names, organizations, and code text, you need to see the original PDF document. I am providing just informal, short notes here.

  1. CxBladderDetect+, Pacific Edge, urine-based MAAA (ddPCR), 0420U
  2. Colosense, Geneoscopy, colorectal screening MAAA, 0421U
  3. Guardant360 Response, pan-solid-tumor response to anti-cancer therapy (cfDNA), 0422U
  4. Genomind PGx Report Full, 26 gene PGx, 0423U
  5. miR Sentinel, miR LLC, prostate non coding RNAs, urine, risk, 0424U
  6. RCIGM WGS, Rady Children's, rapid WGS analysis, comparator genomes, 0425U
  7. RCIGM WGS, Rady Childrens, rapid WGS, child, 0426U
  8. Early Sepsis Indicator, Beckman, monocyte distribution (w/ 85004, 85025) +0427U
  9. ctDNA, Metastatic Breast Cancer, EPIC, ctDNA, 56 genes, 0428U
  10. Omnipathology HPV, Omnipathology, 14 HPV, oral, 0429U
  11. Malabsorption Panel, Mayo, multi markers, feces, 0430U
  12. Glycine Rec Ab, Mayo, 0431U, CSF, live cell binding, 0431U
  13. Kelch Like Protein, Mayo, serum or CSF, 0432U
  14. EpiSwitch Prostate, Oxford Biodynamics, blood, likelihood cancer, 0433U
  15. RightMed, OneOme (excl. F2 F5), drug metabolism, 25, 0434U
  16. ChemoID, Cordgenics, Cancer stem cells, drug response, 0435U
    1. Note that another company in this space, Kiyatek, obtained two codes 0324U 0325U, then deleted them (eff 4/2023).  
  17. PROphet NSCLC, OncoHost, plasma analysis of 388 proteins, Checkpoint response, 0436U
  18.  MindX One, MindX Sci, 15 biomarkers, anxiety disorders, 0437U
  19. Effective Rx, GENETWORx, 33 genes, drug metabolism, 0438U

Revisions

NavDx (Naveris Inc) test, 0356U, ddPCR cfDNA biomarkers, 17 bioomarkers, add "^anal" to "oropharyngeal."

MeMed BV, bacterial infection risk, add "^or venous whole blood" to "serum".

Notes

Although there are quite a few PLA codes, a half dozen, eg 0414U, that incorporate AI or ML terminology, or equivalent terminology, no new ones are prominent in the new listing.

At least two codes include droplet digital PCR, 0356U and 0420U.  Optical Genome Mapping is in a number of PLA codes (including eg 0413U).