Effective October 1, 2025, the American Medical Association (AMA) introduced 25 new Proprietary Laboratory Analyses (PLA) codes, along with two deletions and one revision [1]. For U.S. labs and billing teams, these changes are more than just paperwork – they directly impact claims, revenue, and compliance.
With the right approach and tools like RevGen-i, labs can implement these updates efficiently, minimize errors, and safeguard revenue.
What Are PLA Codes and Why They Matter for Lab Billing
PLA codes represent specialized clinical lab tests that may be offered by a single laboratory or licensed to multiple providers. These codes cover advanced diagnostics such as oncology panels, transplant monitoring, and rare disease sequencing.
Accurate coding is crucial for U.S. labs and billing teams. Proper PLA code usage ensures claims are processed correctly, reduces denials, and helps capture full reimbursement for proprietary lab analyses.
PLA Code Updates: New, Revised, and Deleted Codes
The October 2025 AMA updates introduce several significant changes:
Deleted Codes: 0450U and 0451U, both related to multiple myeloma testing using LC-MS/MS.
Revised Code: 0333U now applies only to the HelioLiver™ Test by Helio Genomics® for liver oncology surveillance.
New Codes: 25 new PLA codes span oncology, transplant, neuro, infectious disease, and gastrointestinal diagnostics. Key additions include:
- 0575U – HepatoTrack™ Liver RT-PCR 4 Genes, LuminoDx Inc
- 0577U – GlycoKnow™ Ovarian, InterVenn Biosciences
- 0585U – Labcorp® Plasma Complete™ cfDNA Panel
- 0596U – Precivity-ApoE™, C2N Diagnostics
Labs should review the full list and ensure their U.S. lab billing services are updated to reflect these changes, verifying each code against internal testing menus and payer requirements.
Why Labs Should Act Fast on PLA Code Changes
PLA code updates are more than just administrative housekeeping – they directly impact revenue, compliance, and operational efficiency. Acting quickly ensures your lab billing services team stays ahead of potential issues.
Revenue Accuracy is critical. Submitting a claim with the wrong PLA code can lead to denials, delayed payments, or under-reimbursement.
Regulatory Compliance is another key factor. PLA codes are proprietary, and incorrect coding can trigger audits or compliance flags.
Workflow Efficiency matters too. Updating codes manually can be time-consuming and error-prone, slowing down your entire claims process.
Streamline Lab RCM with RevGen-i
Implementing PLA code updates doesn’t have to slow your lab down. RevGen-i, 3Gen Consulting’s AI-driven billing platform, acts as a smart co-pilot for U.S. lab billing services.
With RevGen-i, labs can:
- Update new, revised, and deleted PLA codes across billing workflows
- Validate test-to-code mapping to ensure claims are submitted accurately
- Track potential denials and rework tied to proprietary lab tests
- Generate real-time analytics to monitor revenue trends and reimbursement patterns
By integrating RevGen-i, labs can reduce manual errors, improve efficiency, and protect revenue – all while staying compliant with AMA coding requirements.
Takeaway: Stay Ahead in U.S. Lab Billing
The October 2025 PLA code updates are live, and labs that act proactively will benefit from smoother workflows, accurate claims, and optimized revenue. Leveraging smart tools like RevGen-i ensures that PLA code changes are implemented seamlessly, letting billing teams focus on efficiency rather than errors.
For labs looking to strengthen their lab billing services, accuracy alone isn’t enough. Proactive workflow management and AI-enabled automation are key to staying ahead in today’s evolving coding landscape.
Contact us to learn how RevGen-i can simplify PLA code updates for your lab.
References
[1] AMA, “CPT® Proprietary Laboratory Analyses (PLA) Codes: Long Descriptors,” 1 October 2025. Available: https://www.ama-assn.org/system/files/cpt-pla-codes-long.pdf.
