Start Using These 7 PLA Oncology Codes on July 1, 2018

proprietary laboratory analyses codes

We’ve been on a roll with coding updates lately, so let’s keep that momentum going! The July 2018 updates are bringing changes for Proprietary Laboratory Analyses (PLA) CPT® codes. The codes won’t be published in the printed manual until 2019, but the updates are effective July 1, 2018.

Seven of the 17 new codes are specific to oncology, and we’ll focus on those. Below are the proprietary names and clinical labs/manufacturers as well as the short descriptors, with a little more information on the tests.

0045U: DCIS Test

  • 0045U
  • The Oncotype DX® Breast DCIS ScoreTM Test
  • Genomic Health
  • ONC BRST DUX CARC IS 12 GENE
  • This test is typically performed on tissue from a ductal carcinoma in situ (DCIS) tumor after removal. The score results provide information on how likely cancer is to recur in the next 10 years.

0047U: Prostate Cancer Gene Activity

  • 0047U
  • Oncotype DX Genomic Prostate Score
  • Genomic Health
  • ONC PRST8 MRNA 17 GENE ALG
  • This assay checks prostate cancer gene activity and provides a score, which also takes into account clinical risk factors, to assess how aggressive a tumor is.

0048U: Tumor Test

  • 0048U
  • MSK-IMPACT (Integrated Mutation Profiling of Actionable Cancer Targets)
  • Memorial Sloan Kettering Cancer Center
  • ONC SLD ORG NEO DNA 468 GENE
  • This is a qualitative assay used to detect tumor gene alterations. Understanding the genetics of the patient’s cancer helps providers and patients make treatment decisions, including clinical trial participation.

0053U: Prostate Cancer Risk

  • 0053U
  • Prostate Cancer Risk Panel
  • Mayo Clinic
  • Laboratory Developed Test
  • ONC PRST8 CA FISH ALYS 4 GEN
  • This fluorescence in situ hybridization test is aimed at assisting with determining the probability of a higher prostate tumor grade. The genes analyzed are ASAP1, HDAC9, CHD1, and PTEN.

0057U: Solid Organ Neoplasm Profiling

  • 0057U
  • RNA-Sequencing by NGS
  • OmniSeq
  • Life Technologies Corporation
  • ONC SLD ORG NEO MRNA 51 GENE
  • This code applies to tests on solid organ neoplasms. It involves gene expression profiling for analysis of 51 genes.

0058U: Merkel Cell Quantitative

  • 0058U
  • Merkel SmT Oncoprotein Antibody Titer
  • University of Washington, Department of Laboratory Medicine
  • ONC MERKEL CLL CARC SRM QUAN
  • This code is specific to detection of antibodies to the Merkel cell polyoma virus oncoprotein. It’s a quantitative test.

0059U: Merkel Cell Positive/Negative

  • 0059U
  • Merkel Virus VP1 Capsid Antibody
  • University of Washington, Department of Laboratory Medicine
  • ONC MERKEL CLL CARC SRM +/-
  • This code is similar to 0058U, but the descriptor specifies “detection of antibodies to the Merkel cell polyoma virus capsid protein (VP1),” and the result is reported as positive or negative.

What About You?

Do you use PLA codes? Are you glad they get updated more than once a year?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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