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PLA Codes

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2019
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CodeMap® Compliance Briefing: February 10, 2017


Editor's Welcome:

The Providing Access to Medicare Act of 2014 (PAMA) has resulted in two new ways for clinical laboratories and diagnostic manufacturers to secure procedure codes and Medicare reimbursement for newly developed tests. First, laboratories may choose to apply to have their new test classified as an Advanced Diagnostic Laboratory Test (ADLT) pursuant to the PAMA regulations. Second, either laboratories or manufacturers may apply for new Proprietary Laboratory Assay (PLA) codes developed by the AMA. Considering the first PAMA based Medicare Clinical Laboratory Fee Schedule will become effective January 2018, it is not too soon to start planning for how to code and bill for new tests that your laboratory may develop and offer in the near future. T....

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