COVID-19 Specimen Collection Codes
Clinical diagnostic laboratories can identify specimen collection for COVID-19 testing using two new HCPCS Level II codes, effective March 1, 2020.
Check Patient Location Before Coding
Medicare posted these new specimen collection codes in a March 31, 2020, special edition MLN Connects and in a last-minute revision to the April 2020 HCPCS Level II quarterly update file:
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source
G2024 Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency, any specimen source
As the descriptors reveal, both G2023 and G2024 apply to collection of “any specimen source,” which means you should not restrict your use of these codes based on the source of the specimen. For instance, you should not assume the codes apply only to nasal swabs. The reference to “any specimen source” also may allow you to continue to use these collection codes as the industry develops new COVID-19 tests that use different specimen sources.
In an interim final rule related to COVID-19 policy and regulatory revisions, the Centers for Medicare & Medicaid Services (CMS) explains that tests that allow patients to collect the specimen would not be eligible for the specimen collection fee. Trained personnel must collect the sample.
Expect Higher Fee for G2024
The only variation between the G2023 and G2024 code descriptors is this wording in G2024: “from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency.”
The interim final rule states the second code, G2024, is necessary because the Social Security Act and CMS regulations “require a higher fee for collecting a specimen from an individual in a SNF [skilled nursing facility] or by a laboratory on behalf of an HHA [home health agency].”
The nominal specimen collection fee for COVID-19 testing for homebound and non-hospital inpatients “generally will be $23.46,” according to the interim final rule. For individuals in a SNF or for individuals whose samples will be collected by a laboratory on behalf of an HHA, the fee will be $25.46. These fees are higher than the typical specimen collection fees of $3 to $5, reflecting the higher costs required to minimize exposure risks.
Anyone who will be reporting G2023 and G2024 should review the interim final rule, particularly starting around page 95, to be sure they have viewed the official requirements, including the definition of homebound.
G2023 and G2024 Are Required but May Be Temporary
Independent labs must use G2023 and G2024 to bill Medicare for the specimen collection fee for COVID-19 testing during the public health emergency (PHE), the interim final rule states.
The MLN Connects post specifies that the codes are “effective with line item date of service on or after March 1, 2020.” Watch for CMS to issue additional guidance once the PHE is over and when the codes are no longer valid for reporting.
Just the Latest COVID-19 Codes
HCPCS Level II specimen collection codes G2023 and G2024 aren’t the only recent additions related to COVID-19. They join new HCPCS Level II COVID-19 testing codes and a new CPT® COVID-19 testing code. ICD-10-CM has also added a new code, U07.1 COVID-19, with official coding guidelines.
More information on testing codes is available here.