AMA Reviewing Changes to the Tumor Gene Panel Codes (81445-81455; CGP)

UPDATE.  AMA HAS SET THE COMMENT DEADLINE AS AUGUST 16 (REQUEST PERMISSION TO COMMENT) and AUGUST 23 (SUBMIT THE COMMENT).

http://www.discoveriesinhealthpolicy.com/2021/08/ama-revamping-genomic-tumor-codes-cgp.html

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Original August 2 blog below.

AMA has 3 codes for tumor genes panels, 81445 (5-50 genes), 81450 (5-50 genes, if hematopoietic cancer), and 81455 (51 genes or more.)   The MolDx program, which processes the lion's share of CPT molecular pathology codes, does not recognize 81455 and uses 81479 (other test) instead.

After many months of rumors, AMA CPT has announced it is planning revisions to the tumor panel 81445-81450-81455.  See the agenda here.

 

Process for 81455 Revisions Has Been Atypical

Normally, AMA releases lab CPT code proposals in mid July, with an early comment period such as July 23-29.  Then, AMA releases all the other codes in late July, with a different comment period, until mid-September.

As I documented in mid-July, AMA released a list of 8 lab codes for the fall CPT meeting.  My blog here, cloud 8-code agenda here.   When AMA updated the agenda on July 30, it added dozens of codes on other topics, AND IT ALSO ADDED THE 81455 AGENDA ITEM.  That means there are now "9" lab code agenda items. See the July 30 version here.

Normally, AMA would want lab-code comments by July 29, but that hardly seems fair for 81455 revisions, since they weren't posted until July 30.  See the Agenda (previous link) for instructions on page 1 for how to request a code packet and how to comment on it.  Members of the CPT panel will be able to review your comments in a private cloud library.

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Additional Aspects

There's been concern that CGP is too often unavailable to cancer patients; see the Access to CGP Coalition here.  

On July 22, 2021, AMA held a day-long virtual meeting on molecular coding policy, problems, and solutions, pic below.  AMA promised to release an article or white paper summarizing the conference.

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