MPFSDB October Update Clarifies Code Payment

MPFSDB October Update Clarifies Code Payment

Revised instructions indicate payment status for new CPT codes.

The Centers for Medicare & Medicaid Services (CMS) has issued changes to the October update of the 2020 Medicare Physician Fee Schedule Database (MPFSDB) that you do not want to ignore. Among the revisions relayed in MLN Matters 11939, issued Oct. 27, are the anticipated payment instructions for a recently-added CPT® code.

Medicare Assigns Procedure Status for 99072

The CPT® Editorial Panel recently approved a new code for physicians to use to report additional supplies, materials, and clinical staff time required to support safe in-person patient interactions with healthcare professionals during the public health emergency for COVID-19.

99072 Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease

Although this code is effective for dates of service (DOS) on or after Sept. 8, 2020, CMS has assigned it a Procedure Status B Bundled code with Global Days XXX Global concepts to not apply.

No RVUs for These New Codes

CMS has also determined the procedure status for four other new CPT codes. The following new codes are assigned procedure status X Ancillary service; there are no relative value units (RVUs) for these codes:

87426 Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19]); effective June 25, 2020 (CMS implemented this code under CR 11736, but we wanted to reiterate.)

86408 Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID19]); screen; effective Aug. 10, 2020

86409 Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID19]); titer; effective Aug. 10, 2020

86413 Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative; effective Sept. 8, 2020

More Code Revisions

CMS has reassigned 0599T Noncontact Real-Time Fluorescence Wound Imaging, For Bacterial Presence, Location, And Load, Per Session; Each Additional Anatomic Site (Eg, Upper Extremity) (List Separately In Addition To Code For Primary Procedure) Global Days indicator ZZZ Add-on code; effective July 1, 2020.

Lastly, the following short descriptors are revised:

  • G2011 Alcohol/sub misuse assess (effective Oct. 1, 2020)
  • J9305 Inj. pemetrexed nos 10mg (effective Oct. 1, 2020)
  • 86318 Ia infectious agent antibody (effective April 10, 2020)
  • 3170F Baselin flo cytometry b/4 tx (effective May 20, 2020)

See MLN Matters article MM11939 Revised for complete details.

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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.

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