The draft code agenda has been released (here, may require free registration).
Topics include McKesson quarterly codes; 3 proposals for new genetic codes; new telemedicine codes; and revisions to the AMA CPT literature requirements. More after the break.
McKesson and AMA
There is a proposal to use the "McKesson Infrastructure" for proprietary code reporting. This is probably keyed to the PAMA Section 216 mandate that new, more specific codes will be created rapidly for ADLT and FDA approved tests. These could be, or resemble, Z identifiers and be incorporated into the HIPAA system by inclusion in the AMA CPT system. To be determined. (Tab 40).
This adds detail to the public deck posted after the February 2016 AMA CPT MoPath workshop (pp, and posted publicly online at AMA (here, p. 12 ff). The concept was then called "PLA" for Proprietary Laboratory Analysis codes, and several work sessions led up to the February 2016 presentation. PLA codes would be for commercially available tests; requested by the lab or manufacturer; not physician servies; FDA cleared or approved, OR a sole source laboratory. The plan at that time was that PLA codes would not be co-reported with other CPT codes but would override (be used instead of) another CPT code. The codes would be reviewed for clarity and consistency but not for utilization or depth of literature. They would probably be available quarterly, even faster than the recently established "Administrative MAAA codes."
Just Three Genomic Codes
The quiet period for new genomic codes continues. There is a code proposal for a cancer stem cell cytotoxicity test involving CD133. There is a proposal to bump hemoglobin subunit beta sequencing for thalassemia (HBB) from Tier 2 to Tier 1. There is a Tier 1 MAAA test for multiple myeloma. (Tabs 20-22).
Telemedicine Advances
Ten codes for asynchronous telemedicine are being proposed, part of the escape velocity for modern digital health services that is running past legacy fee for service Medicare benefits (Tab 9). Also some telehealth definitions will be modified (Tab 38). This may be an output of the AMA telemedicine workgroup that has been running for several quarters, to be sure that AMA and CPT keep up to date in this area.
Literature Required for Code Submission
There will be an editorial change to the description of required literature when CPT codes are submitted for consideration (Tab 35).