Question:

What are PLA codes?

Answer:

Proprietary Laboratory Analyses (PLA) codes, established by the AMA CPT Editorial Panel in response to the Protecting Access to Medicare Act (PAMA) of 2014, are alphanumeric CPT® codes with a corresponding descriptor for labs or manufacturers that want to more specifically identify their testing. In its final rule for implementing PAMA, CMS defined advanced diagnostic laboratory tests (ADLTs) as tests developed and offered by a single lab that use a unique algorithm to analyze multiple DNA, RNA, or protein markers, and which provide new clinical diagnostic information that can’t be obtained by any other test. While PLA codes aren’t restricted to ADLTs and clinical diagnostic laboratory tests (CDLTs), as defined under PAMA, tests assigned to PLA codes must be performed on human specimens and must be requested by the manufacturer or clinical laboratory that offers the test. There are limiting factors that determine the appropriate use of the PLA CPT codes. Hence the name—proprietary laboratory analysis—for this code set.

This question was answered in our Coding Essentials for Laboratories. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

Facebook
Twitter
LinkedIn
Email
Print

CPT® copyright 2021 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.