Wednesday, January 31, 2024

Medicare Nerd Tip: A Back Door to Putting Together Labs and their PLA Codes

Header: Michigan Blue Cross publishes a PDF which lists every PLA code, name of test, and name of lab owner.  You can't easily get this from AMA or CMS.

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One of the pitfalls of PLA codes is that there are some 500 of them, and they are in random order (from date of approval).   Another problem is that it's very painful to search the AMA CPT manual page by page looking for all the PLA codes a lab (say, Biodesix) might have.  The CMS CLFS fee schedule and even the subscription AMA RVU database, list PLA codes but not owners.

Aha.  Michigan Blue Cross publishes a PDF of all active PLA codes, with the code number, the code name (or brand name like "Cxbladder-TM", and then the owner.  Since this is a PDF file, you can search it for keywords (say, Biodesix).  This shows in a second that Biodesix has 2 PLA codes,  PLA 0080U for BDX-XL2 test, and 0360U for Nodify CDT test.

Find the table here:

https://www.bcbsm.com/amslibs/content/dam/public/mpr/mprsearch/pdf/2158372.pdf


AI Corner

This is how GPT4 created the illustration from the blog text alone.

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GPT4:

For your blog header, it sounds like you're looking for an illustration that captures the essence of navigating through the complexities of Proprietary Laboratory Analyses (PLA) codes, highlighting the unique resource provided by Michigan Blue Cross. Given the content, an effective illustration could depict a maze of PLA codes leading to a simplified, clear guide, symbolizing the PDF published by Michigan Blue Cross as a key to unlocking this maze.

Imagine a visual metaphor where the maze walls are made up of jumbled PLA codes and names, with frustrated healthcare professionals or researchers navigating through it. In contrast, one figure could be shown confidently walking a straight path, thanks to the guiding light or map provided by the Michigan Blue Cross PDF, symbolized by a glowing document or a magnifying glass highlighting the codes for "Biodesix."

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This illustration will communicate the blog's key message visually: that while navigating PLA codes can be a daunting task due to their disorganized nature and the lack of comprehensive, user-friendly resources from AMA and CMS, Michigan Blue Cross offers a valuable solution that simplifies this process.

Would you like me to proceed with creating an image based on this description?

ME: YES

Here's the illustration capturing the essence of navigating through the complexities of Proprietary Laboratory Analyses (PLA) codes and the clarity provided by the Michigan Blue Cross PDF. This visual metaphor illustrates the contrast between the maze of PLA codes and the straightforward path made possible by the valuable resource from Michigan Blue Cross. I hope this aligns well with your vision for the blog header!