New COVID-19 Testing Codes

New COVID-19 Testing Codes

During an emergency meeting in response to the COVID-19 crisis, the American Medical Association (AMA) convened the CPT® Editorial Panel to approve a new pair of Category 1 CPT® codes. These two new codes are effective immediately, according to the AMA.
“The new codes are intended for use as the industry standard for accurate reporting and tracking of blood tests performed to specifically detect antibodies associated with the SARS-CoV-2 virus,” according to the AMA release.

New Codes for Antibody Testing

The new codes are:

  • 86328 Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])
  • 86769 Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])

CPT® 86328 is for antibody tests using a single-step method immunoassay. This often includes a strip with all of the critical components for the assay, and is appropriate for a point of care platform, according to an AMA press release. CPT® 86769 is for antibody tests employing a multiple-step method.

For more up-to-date information on testing codes, click here.

Antibodies Show Promise

“Antibody testing that identifies patients that have been exposed to the novel coronavirus (SARS-CoV-2) and developed an immune response is likely to have important public health implications by providing a clearer picture of the prevalence of the disease in the U.S.,” said AMA President Patrice A. Harris, MD, MA, in the press release. “The expedited approval of new CPT® codes for COVID-19 antibody tests is an important step that enhances the reporting of innovative tools now available to advance medicine’s overarching goals of reducing the COVID-19 disease burden, improving health outcomes and reducing long-term care costs.”
The AMA has released a free CPT® Assistant Special Edition: April Update to guide the healthcare industry on using these new codes.

code-books-shipping

Latest posts by Chris Boucher, CPC (see all)

About Has 3 Posts

Chris Boucher, CPC, has 10 years of experience writing various newsletters and other products for The Coding Institute. His blog covers several areas of coding and compliance, including CPT® coding, modifiers, HIPAA compliance, and ICD-10 coding.

9 Responses to “New COVID-19 Testing Codes”

  1. Cindy says:

    Thanks for the article. This is good news. Has there been any reimbursement information on these two codes? Thanks again for the information

  2. Marlene Shorey says:

    Question – The 2 new CPT codes, do you know when to expect them on the Medicare Fee schedule? I am looking speciftfor CPT 86328v I keep checking each day. I am trying to get code loaded o to my EhR and priced, and o l ow our team used fees from Medicare fee schedule as a guide. Do you lknow when we can expect to see the code on any geek schedule?

  3. Renee Dustman says:

    Codes 86328 and 86979 are available for reporting beginning April 10, 2020. Contact your third party payer to determine their guidelines regarding reimbursement

    https://www.ama-assn.org/system/files/2020-04/cpt-assistant-guide-coronavirus-april-2020.pdf

  4. Susan Heiss says:

    The CPT codes 86769 and 86328, do you know when Medicare will report the reimbursement?

  5. Renee Dustman says:

    I believe the April 2020 MPFSDB has been updated.

  6. MaryNell Goolsby says:

    Do you have recommended ICD-10 codes for coverage? Z03.818? Z20.828? Will Z11.59 be covered for antibody testing?

  7. Renee Dustman says:

    MaryNell: Z03.818 is used for an asymptomatic patient with possible exposure to COVID-19 and the patient tests negative. Z20.828 is used for a patient known or suspected to be exposed to COVID-19, who is exhibiting symptoms, but test results are negative, inconclusive or unknown.

    Report U07.1 if test results are positive.

  8. Tiffany says:

    What is the appropriate COVID 19 testing code for specimen/swab collection in a doc office? I read that Medicare is allowing 99211 for this test via doc office. Is that accurate?

  9. Renee Dustman says:

    Tiffany: Yes, per a CMS Fact Sheet, dated 4.29.2020, “Practitioners can be paid for assessment and specimen collection for COVID-19 testing using the level 1 evaluation and management code CPT code 99211. In light of the public health emergency, Medicare will recognize this code to be billed for all patients, not just established patients.”

Leave a Reply

Your email address will not be published. Required fields are marked *