Brief Blog: AMA CPT Releases New Code Applications for Review (CPT & PLA)

Header:  For lab tests, PLA applications are quarterly, and regular CPT applications are 3 times a year.  In July, they overlap.  AMA has released, with the opportunity for public comment, information on CPT lab applications submitted in June and information on PLA lab applications submitted in June.

CPT CATEGORY 1

Here's the website for the CPT meeting in September in Albuquerque:

https://www.ama-assn.org/member-benefits/events/cpt-editorial-panel-meeting

Here's the agenda for lab codes for that meeting:

https://www.ama-assn.org/system/files/september-2024-lab-mopath-agenda.pdf

There will be an update to PLA code guidelines, regarding upgrading your PLA code from PLA to "Category I."  I have not seen the editorial change, but only some PLA codes are eligible for such "upgrades," there has to be a CPT section (like the "MAAA" section) that the PLA code could be upgraded-into.

There are two other items, an application for "dekeratization procedure" andan applicaton for an add on code for "infrared exam of surgical specimen' (category III).

PLA CODES

Her'es the website for PLA:

https://www.ama-assn.org/practice-management/cpt/cpt-pla-codes

Here's the listing of PLA codes submitted in June and therefore being reviewed in July-August:

https://www.ama-assn.org/system/files/august-2024-pla-public-agenda.pdf

• There ar 20 PLA actions. 
• 5 are code deletions.
• 2 are code revisions.

Guardant SHIELD, for colorectal screening, analysis of multiple biomarkers with a categorical result.

Pillar oncoREVEAL, an FDA PMA cut running on an Illumina platform, has deletion of its "lung and colon cancer" code 0448U, concurrent with application for an all-new, pan-cancer code (reflecting updated FDA labeling).  It is a 22-gene panel.

Quest DELETES 0436U, Abeta 40, 42.  This got an underpriced crosswalk in fall 2023 which is reflected on the current 2024 clin lab fee schedule ($93).  A range of new ALZ codes are in play for 2025, at this summer's pricing meetings, and it is a good that 0436U is deleted as a crosswalk target.

Abbott and Biofire each apply for infectious disease PLA codes.  Abbott for an HSV1,HSV2, Varicella test, and Biofire for an elaborate pneumonia test with 18 bacteria, 8 viruses, and 7 resistance genes.