General Surgery Coding Alert

Tennessee Subscriber

Answer: Centers for Medicare and Medicaid Services (CMS) recently updated the list of acceptable codes for modifier CS (Cost-sharing waived for specified covid-19 testing-related services that result in and order for or administration of a covid-19 test …).

Backtrack: Starting on March 18, 2020, the Families First Coronavirus Response Act (FFCRA) mandated that, for the duration of the Public Health Emergency (PHE), Part B providers append modifier CS to any E/M service resulting in the provider either administering or ordering a COVID-19 lab test for the patient.

CMS added the following six new codes that Medicare will accept with the CS modifier through the end of the PHE for dates of service on or after Jan. 1, 2021, an MLN Connects indicates.

HCPCS codes:

• G2250 (Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward…)
• G2251 (Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services… 5-10 minutes of clinical discussion)
• G2252 (Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion)

CPT^® codes:

• 98970 (Qualified nonphysician health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes)
• 98971 (… 11-20 minutes)
• 98972 (… 21 or more minutes)

“These [codes 98970-98972] replace HCPCS codes G2061-G2063, which are accepted for services provided in 2020,” CMS says in the release. “CPT^® codes 98966, 98967, and 98968 are accepted for services with the CS modifier provided on or after March 18, 2020.”