Home 5 Articles 5 CMS Adds New PLA Oncology, ELISA, Reproductive Codes to HCPCS

CMS Adds New PLA Oncology, ELISA, Reproductive Codes to HCPCS

by | Jul 28, 2021 | Articles, Coding-lca, Essential, Lab Compliance Advisor

CMS added seven new PLA codes to the HCPCS files, effective July 1, 2021, which will be contractor-priced based on local rates until they undergo the CLFS annual payment determination process for national pricing. Laboratory CPT Code Long Descriptor Short Descriptor TOS 3D Predict Glioma, KIYATEC, Inc 0248U Oncology (brain), spheroid cell culture in a 3D microenvironment, 12 drug panel, tumor-response prediction for each drug ONC BRN SPHRD CLL 12 RX PNL 5 Theralink Reverse Phase Protein Array (RPPA), TheralinkTechnologies, Inc, Theralink Technologies, Inc 0249U Oncology (breast), semiquantitative analysis of 32 phosphoproteins and protein analytes, includes laser capture microdissection, with algorithmic analysis and interpretative report ONC BRST ALYS 32 PHSPRTN ALG 5 PGDx elioTM tissue complete, Personal Genome Diagnostics, Inc, Personal Genome Diagnostics, Inc 0250U Oncology (solid organ neoplasm), targeted genomic sequence DNA analysis of 505 genes, interrogation for somatic alterations (SNVs [single nucleotide variant], small insertions and deletions, one amplification, and four translocations), microsatellite instability and tumor-mutation burden ONC SLD ORG NEO DNA 505 GENE 5 Intrinsic Hepcidi IDxTM Test, IntrinsicDx, Intrinsic LifeSciencesTM LLC 0251U Hepcidin-25, enzyme-linked immunosorbent assay (ELISA), serum or plasma HEPCIDIN-25 ELISA SERUM/PLSM 5 POC (Products of Conception), Igenomix, Igenomix USA 0252U Fetal aneuploidy short tandem–repeat […]

CMS added seven new PLA codes to the HCPCS files, effective July 1, 2021, which will be contractor-priced based on local rates until they undergo the CLFS annual payment determination process for national pricing.

LaboratoryCPT CodeLong Descriptor Short DescriptorTOS
3D Predict Glioma, KIYATEC, Inc0248UOncology (brain), spheroid cell culture in a 3D microenvironment, 12 drug panel, tumor-response prediction for each drugONC BRN SPHRD CLL 12 RX PNL5
Theralink Reverse Phase Protein Array (RPPA), TheralinkTechnologies, Inc, Theralink Technologies, Inc0249UOncology (breast), semiquantitative analysis of 32 phosphoproteins and protein analytes, includes laser capture microdissection, with algorithmic analysis and interpretative reportONC BRST ALYS 32 PHSPRTN ALG5
PGDx elioTM tissue complete, Personal

Genome Diagnostics, Inc, Personal Genome

Diagnostics, Inc

0250UOncology (solid organ neoplasm), targeted genomic sequence DNA analysis of 505 genes, interrogation for

somatic alterations (SNVs [single nucleotide variant], small insertions and deletions, one amplification, and four translocations), microsatellite instability and tumor-mutation burden

ONC SLD ORG NEO DNA 505 GENE5
Intrinsic Hepcidi IDxTM Test, IntrinsicDx,

Intrinsic LifeSciencesTM LLC

0251UHepcidin-25, enzyme-linked immunosorbent assay (ELISA), serum or plasmaHEPCIDIN-25 ELISA SERUM/PLSM5
POC (Products of Conception), Igenomix,

Igenomix USA

0252UFetal aneuploidy short tandem–repeat comparative analysis, fetal DNA from products of conception, reported as normal (euploidy), monosomy, trisomy, or partial deletion/duplications, mosaicism, and segmental aneuploidyFTL ANEUPLOIDY STR ALYS DNA5
ERA (Endometrial Receptivity Analysis),

Igenomix, Igenomix USA

0253UReproductive medicine (endometrial receptivity analysis), RNA gene expression profile, 238 genes by next generation sequencing, endometrial tissue, predictive algorithm reported as endometrial window of implantation (e.g., pre-receptive, receptive, post-receptive)RPRDTVE MED RNA GEN PRFL 2385
SMART PGT-A (Preimplantation Genetic

Testing – Aneuploidy), Igenomix, Igenomix USA

0254UReproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using embryonic DNA genomic sequence analysis for aneuploidy, and a mitochondrial DNA score in euploid embryos, results reported as normal (euploidy), monosomy, trisomy, or partial deletion/duplications, mosaicism, and segmental

aneuploidy, per embryo tested

REPRDTVE MED ALYS 24 CHRMSM5

CMS also added CPT Code G0327, Colorectal cancer screening; blood-based biomarker (Colon ca scm;bld-bsd biomark) to the national HCPCS file, effective July 1.

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