New Codes Effective July 1, 2019 – Proprietary Laboratory Analysis (PLAs)

The following new codes may need to be manually added to the HCPCS file by the MACs with an effective date of July 1, 2019. These new codes are also contractor-priced until they appear on the January 1, 2020 CLFS as applicable. 

Note: MACs will only price PLA codes for laboratories within their jurisdiction. 

CPT Code: 0084U 

Short descriptor: RBC DNA GNOTYP 10 BLD GROUPS 

CPT Code: 0085U 

Short Descriptor: CDTB&VINCULIN IGG ANTB IA 

CPT Code: 0086U 

Short Descriptor: NFCT DS BACT&FNG ORG ID 6+ 

CPT Code: 0087U 

Short Descriptor: CRD HRT TRNSPL MRNA 1283 GEN 

CPT Code: 0088U 

Short Descriptor: TRNSPLJ KDN ALGRFT REJ 1494 

CPT Code: 0089U 

Short Descriptor: ONC MLNMA PRAME & LINC00518 

CPT Code: 0090U 

Short Descriptor: ONC CUTAN MLNMA MRNA 23 GENE 

CPT Code: 0092U 

Short Descriptor: ONC LNG 3 PRTN BMRK PLSM ALG 

CPT Code: 0093U 

Short Descriptor: RX MNTR 65 COM DRUGS URINE 

CPT Code: 0094U 

Short Descriptor: GENOME RAPID SEQUENCE ALYS 

CPT Code: 0095U 

Short Descriptor: INFLM EE ELISA ALYS ALG 

CPT Code: 0096U 

Short Descriptor: HPV HI RISK TYPES MALE URINE 

CPT Code: 0097U 

Short Descriptor: GI PATHOGEN 22 TARGETS 

CPT Code: 0098U 

Short Descriptor: RESPIR PATHOGEN 14 TARGETS 

CPT Code: 0099U 

Short Descriptor: RESPIR PATHOGEN 20 TARGETS 

CPT Code: 0100U 

Short Descriptor: RESPIR PATHOGEN 20 TARGETS; 

CPT Code: 0101U; 

Short Descriptor: HERED COLON CA DO 15 GENES 

CPT Code: 0102U 

Short Descriptor: HERED BRST CA RLTD DO 17 GEN 

CPT Code: 0103U

Short Descriptor: HERED OVA CA PNL 24 GENES

CPT Code: 0104U 

Short Descriptor: HERED PAN CA PNL 32 GENES 

Deleted Codes Effective July 1, 2019 

• Existing code 0057U is being deleted.

 

CR#:R4296CP

Source: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM11280.pdf