New CPT Code for Reporting COVID-19 Test

New CPT Code for Reporting COVID-19 Test

On Jan. 30, the World Health Organization (WHO) declared the 2019 novel coronavirus (COVID-19) disease outbreak a public health emergency of international concern. The outbreak has since been elevated to a pandemic and President Trump has declared the coronavirus pandemic a national emergency in the United States. Communities across the country are shutting down to limit public gatherings. The goal is to prevent COVID-19 from infecting the masses, for which our healthcare system is not prepared.

In the interim, new procedure and diagnosis codes and associated guidance have been released. Medical coders and billers in all settings must be ready to use these codes.

UPDATE:

Don’t miss AAPC’s webinar: Telehealth and other Remote Services from a Physician’s Office, March 31, presented by Jill M. Young, CPC, CEDC, CIMC. She will discuss the diagnosis and testing codes for COVID-19, explain the guidelines for remote patient care while the telehealth waiver is in force for Medicare patients, and much more!

New CPT® Code

Most recently, the CPT Editorial Panel approved a new Category I Pathology and Laboratory code for novel coronavirus testing. This code is effective March 13, 2020.

87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19], amplified probe technique

This is an early release code, so you will need to manually upload this code descriptor into your electronic health record system.

CPT® 87635 will be a child code under parent code 87471 Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique in the 2021 CPT® code set.

A special edition CPT® Assistant is publicly available, which provides guidance for using this new code.

Visit the AMA website for more information about this new code.

Medicare Guidance

The Centers for Medicare & Medicaid Services (CMS) has released numerous press releases to convey information and guidance to healthcare providers in specific settings. Click here to go to the CMS webpage that contains a compilation of links to all of these resources.

New HCPCS Level II and ICD-10-CM Codes

There are also two new HCPCS Level II testing codes for reporting Medicare beneficiaries being tested for COVID-19, and a new diagnosis code for reporting confirmed cases of COVID-19. It is essential that healthcare systems begin using these codes to report all COVID-19 testing and confirmed diagnoses. This critical data could potentially save the lives of millions.

Renee Dustman
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Renee Dustman

Executive Editor at AAPC
Renee Dustman, BS, AAPC MACRA Proficient, is an executive editor at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. Renee has more than 20 years experience in print production and content management. Follow her on Twitter @dustman_aapc.
Renee Dustman
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Renee Dustman, BS, AAPC MACRA Proficient, is an executive editor at AAPC. She holds a Bachelor of Science degree in Media Communications - Journalism. Renee has more than 20 years experience in print production and content management. Follow her on Twitter @dustman_aapc.

2 Responses to “New CPT Code for Reporting COVID-19 Test”

  1. Yunita C Tjiadi says:

    Hello, do you know if the PCP office can bill any codes for the collection of the specimen (swab) of Covid19 testing? I have a scenario where the PCP office is collecting the swab but then sending the specimen to outside lab for processing. What code can the PCP bill? Thank you.

  2. Paolo Angelini, MD says:

    We, cardiologists in Houston, tried to organize the collection of data on Covid19 screening in our local Hospitals, but no support. This is the time to act and learn from a unique time experience that should not go by without understanding!
    I would be available for co-starting a simple and realistic study especially centered about ACE2 receptors and use of ACE2 receptors inhibitors.

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