Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment

New Codes Effective October 1, 2019. The following table shows the new codes effective October 1, 2019. All the codes have a Type of Service (TOS) code of 5. These codes are contractor-priced until they appear on the January 1, 2020, CLFS as applicable. MACs will only price Proprietary Laboratory Analysis (PLAs) codes for laboratories within their jurisdiction.

CPT Code	Long Descriptor	Short Descriptor
0105U	Nephrology (chronic kidney disease), multiplex electrochemiluminescent immunoassay (ECLIA) of 2 (TNFR1, TNFR2), and kidney injury molecule-1 (KIM-1) combined with longitudinal clinical data, including APOL1 genotype if available, and plasma (isolated fresh or frozen), algorithm reported as probability score for rapid kidney function decline (RKFD)	NEPH CKD MULT ECLIA TUM NEC
0106U	Gastric emptying, serial collection of 7 times breath specimens, non-radioisotope carbon-13 (13C) spirulina substrate, analysis of each specimen by gas isotope ratio mass spectrometry, reported as rate of 13CO2 excretion	GSTR EMPTG 7 TIMED BRTH SPEC
	Clostridium difficile toxin(s) antigen detection by immunoassay technique, stool, qualitative, multiple-step method	C DIFF TOX AG DETCJIA STOOL

Change  Request  (CR)  Number:  11406

Source: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM11406.pdf