AMA CPT - September in New Orleans
For the September 2023 meeting in New Orleans, AMA has released the full agenda, for both lab and general codes. Unfortunately, the deadline for requesting lab proposals to review and comment, closed on July 14. The agenda for other types of codes, to request for comment, runs all the way to August 31. Find the September CPT agenda here. Find September meeting registration here.
Of note, there is an agenda item (79) to review the process for converting PLA codes to Category I codes. When this occurs, it could occur in one of two ways. If the test is a proprietary MAAA test that meets Cat I criteria (wide acceptance, 5 publications), it could become a MAAA code in the 81500 series. Any other code can't be a proprietary CPT code, but could become a general code for the service. For example, there are multiple optical genomic mapping PLA codes, and AMA could create a "general" CPT code for OGM.
There are a number of codes that involve artificial intelligence. (eg 76, AI generated prostate cancer mapping.). I may be missing something, but I didn't see any Cat I lab code proposals.
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AMA PLA CODES
AMA accepted quarterly PLA applications in early July, and released the applications for review on July 14. There is a process (at the link) for requesting codes to review and comment. The comment cycle is very fast (only a few days) and PLA committee will meet around July 27. Codes will be published October 1 and active January 1. Codes in this batch will be priced by CMS at next summer's CLFS meetings (July 2024).
For full descriptions see the PDF at AMA. Two codes use ddPCR (1, 16.) (*)
- CxBladder Detect+
- urine, ddPCR, 5 genes, bladder cancer risk
- Colosense
- CRC screening, 8 RNA markers, fecal
- Guardant360 Response
- Pan cancer, cfDNA, response to cancer therapy
- Genomind Neuropsych
- 26 genes, psychiatric treatments
- MiR Prostate Cancer
- 53 sncRNAs for risk of prostate cancer (urine exosomes)
- QLear Wound Pathogen
- 28 pathogens, 18 antibiotic resistance genes
- CardioRisk+
- Buccal, cardio risk score with 560,000 SNPs
- RCIGM rapid whole genome comparator
- RCIGM ULTRA rapid whole genome
- Early Sepsis Indicator
- Monocyte distribution
- Epic ctDNA Breast Cancer Panel
- ctDNA for 56 or more genes (LBx)
- Omnipathology Oropharyngeal HPV
- PCR for 14 high risk HPV
- Malabsorption evaluation panel
- 4 fecal biomarkers
- Glycine receptor Alpha1 IgG
- In CSF via live cell binding assay
- Kelch-like Protein 11 Ab
- serum or CSF
- NavDx REVISE
- Revising 0356U ddPCR HPV DNA, blood, w fragmentation patterns
- EpiSwitch prostate screening test
- 5 epigenetic markers in combo with PSA
- BluePrint 80 gene breast cancer profiling
- Basal, luminal, etc
- RightMed exclude F2 F5 report
- 25 genes including drug-gene interactions
- ChemoID
- Cancer cell in vitro sensitivity, 10 or more drugs
- PROphet NSCLC
- 388 proteins, aptamer proteomics, lung cancer response to immunotherapy
- MindX Blood Test Anxiety
- RNA sequencing, blood, anxiety risk
- MeMED BV REVISE
- Revising 0351U Infectious disease assays revised for serum "or whole blood"
- EffectiveRX Comprehensive Panel
- 33 genes, PGx, drug interactions, etc
