Tuesday, January 2, 2024

CMS Posts New PLA Codes from December Decision Cycle

The AMA takes applicaitons for new PLA codes each quarter - and now, about 2 weeks before the start of a quarter - and posts results at the end of the quester.   For example, applications socilicited about December 10, 2023, will be acted on during 1Q24 and released as final on April 1, 2024.

Accordingly, we have the new crop of PLA codes released December 28, 2024.   Find them here (at a website that updates quarterly):

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

PLA-Ology

33 codes were under consideration in October, so about 20 were dropped (from the Venient company).   See my October posting here.

PLA Results for December 31, 2023:

AMA summarizes that there were 2 PLA deletions (0345U, 0416U), and one PLA name revision (0407U).   11 wholly new codes were created.

For details see the AMA PDF link above.

For a brief informal summary, stay here.

  • Deleted 0354U= GenePace HPV panel, 
  • Deleted 0416U=Genetworx infection panel.
  • Revised name, IntelxDKD becomes kidneyintelX.dkd; Relanytix 
    • This tag .dkd has to do with one form of the test newly being FDA approved; it similar to the .xyz tags used for biosimilars)

New codes in brief.  For full discriptions see the AMA PDF.

  • EpiGenCHD, 0439U, cardio SNP scores
  • Precision CHD, 0440U, Cardio Diagnostics, cardio SNP scores
  • IntelliSEP, 0441U, infection panel, algorithm index
  • FebriDx, 0442U, bacterial and CRP POC, Lumos
  • [Neuro] Neurofilament Light Chain, Wash U, 0443U
  • Aventa Fusion Plus, 0444U, 361 genes incl w fusions, FFPE
  • [Neuro] Elecsys Tau and Beta Amy Ratio, Roche, 4445U
  • AISLE Dx, Progentec, 0446u, autoimmune disease activity
  • AISLE DX FLARE, 0447U, autoimmune risk flare
  • OncoReveal Dx, Lung Colon, PILLAR Biosci, 0448U [EGFR, KRAS]
  • UNITY Carrier Screen, lab Billion to One, analysis of 5 or more carrier screening genes, 0449U


The next deadline will be around March 10-15, ahead of the April quarter; check with the AMA PLA website to be sure. 

The next web posting from me will e about January 15, 2024, which will post the proposals submitted to AMA a couple weeks back for 1Q2024 review.