1. M

    Wiki COVID-19 Uninsured Claims after HRSA

    Hello, I need to know how and where to submit claims for covid-19 uninsured patients as COVID-19 Uninsured program (HRSA) has stopped accepting claims for “testing and vaccination March 22, 2022 & April 5, 2022” respectively due to insufficient funds. Thanks!
  2. J

    Wiki How to Code for 4th COVID Vaccine shots?

    Hello Everyone, Because the FDA just approved Moderna/Pfizer on the 4th shot, I am having difficulty finding any materials on the subject. Based on the existing codes, I would assume the following: Pfizer: 91300 - Vaccine 0004A - Injection Booster Moderna: 91306 - Low Dose Vaccine 0064A -...
  3. J

    Wiki Does treatment of COVID-19 with non-EUA drugs disqualify a hospital from receiving CARES Act or ARPA Subsidies

    I'm hearing rumors that hospitals have almost universally stuck with remdesivir to treat COVID-19, in spite of some doctors' preference for other approaches, because they fear losing subsidies if they use something else (e.g., ivermectin). It is my understanding that the CARES Act and ARPA...
  4. T

    Wiki COVID vaccine -BCBS

    We are very recently having issues getting the COVID vaccine administration billed the same a couple of months ago and these were denied. Has anyone else seen this issue and resolved?
  5. C

    Wiki Billing/coding for covid vaccine third dose and flu vaccine at same encounter

    Hello - reaching out to see if anyone has found any specific CMS/payer guidance regarding billing for the covid vaccine and flu vaccine at the same encounter. Our practice is having trouble with Anthem processing the traditional administration codes for the flu vaccine- 90471/2 (when billed with...
  6. K

    Wiki Regen Covid Injection

    I have a patient that was seen via telemedicine by a provider to discuss if they met the criteria to receive the monoclonal antibody injection - Regen Covid. The patient lives with his wife and daughter who both have COVID-19 so he was exposed to the disease. I know I need to use dx code Z20.822...
  7. J

    Wiki Travel Testing for COVID-19

    Hi all, I tried searching for this but unable to find a clear answer. How is everyone coding (ICD-10) their patients receiving COVID-19 tests for travel? I have seen payer guidance that testing for this reason is not covered but I don't see they are advising how to code it.
  8. T

    Wiki Expanded Respiratory Panel and COVID 19 PCR Testing-Coding Question.

    I work for an independent laboratory. I am looking for opinions on how you would code the follow Respiratory Panel with Viruses and Bacterial. I just want to be sure that I am doing everything correctly and by the book. I appreciate any and all feedback. I also would like to know if I should be...
  9. R

    Wiki Covid education vs Covid screening icd 10 correct coding.

    Is z11.52 to be used during the pandemic? Would you consider this documentation as screening for Covid-19 (z11.52)? Reviewed information and literature on COVID infection in pregnancy. Reviewed current status of COVID vaccination, including FDA's EUA of both Moderna and Pfizer...
  10. K

    Wiki COVID-19 Law and Denials for Out of Network

    I work at a Student Health Center for a University where we see lots of kids with out of state insurance. Has anybody else had problems with them denying the COVID-19 testing or Office Visits as out of network? From what I'm reading from the laws that were passed I would think that they...
  11. S

    Wiki Rapid COVID Nasal Swab

    Hello All, I wanted to confirm there wasn't a new code to be used for the RAPID COVID-19 test. All I've seen this far was CPT 87635 for the actual COVID test. The other CPT that were added were for the Antibodies test from what I am reading. This will be coding for an Urgent care as well as a PCP.
  12. R


    When a patient presents with COVID-19, as a hospitalist, can we use the CS modifier? Also when the patient is COVID-19 recovered but we are using diagnosis codes Z09 and Z86.19 can you use the CS mod with that as well?
  13. S

    Wiki Pre-op COVID swab coding

    We are aware of the guidance from Medicare to bill CPT 99211. However, I posed the question to my supervisor about commercial payers. She does not like billing the CPT 99211 for the swab at all because the documentation does not support an e/m service. She states, "If you do not take vitals, you...
  14. B

    Wiki Modifier CS

    Are we to apply modifier CS to the E/M service only, or do we apply it to the COVID test and related tests ordered due to COVID? Thanks!
  15. K

    Wiki Antibody testing

    I need help. I have antibody testing that needs to be billed out but not sure exactly what codes to bill out for IgM, IgG, and IgA test. Do I bill out 3 codes for each one of them? Is it one code? I have found that 86769 is the antibody testing code. Just not sure if I need to bill it out 3...
  16. K

    Wiki COVID testing for asymptomatic Medicare patients

    My practice is getting denials from Medicare for patients who are coming in to get tested to abide by travel mandates in our state, wanting to ensure they don't have the virus before visiting a local family member or just want to be tested for peace of mind. The argument is that the above listed...
  17. I

    Wiki Covid testing sofia 2 sars antigen

    We have a provider using the new rapid test “ Sofia 2 SARS Antigen” test the manufacturer website shows cpt code as pending. Is it appropriate to bill using hicpic U0002 testing by any technique.
  18. K


    Can you bill a 99441 for calling the patient back with their test results of covid being that the physician designate that time to call the patient back and explain results and give counseling on what the next steps are? Or is that considered included in the initial office visit for testing for...
  19. M

    Wiki COVID antibody testing

    We are now seeing a surge of patients who want the COVID antibody testing. They may or may not have been sick from December to present. Is this covered under Cost Sharing? (requiring the CS modifier)? The only thing I am finding is for diagnostic testing.
  20. K

    Wiki Modifier CS? When to use?

    Hello, I am working at a physician's practice that is seeing people to be tested for covid-19. We do not bill labs, our sister hospital does, so this question is in relation to office visit charges: When we see a patient and they are tested for covid-19 do we need to use a modifier CS to signify...
  21. H

    Wiki COVID reimbursement

    Has anyone started receiving reimbursement for rapid COVID testing with using code 87635? I am just getting back to work and trying to catch up on all of the new information.
  22. M

    Wiki COVID-19

    Has anyone seen any updates regarding CPT code 49987?
  23. J


  24. L

    Wiki COVID 19 - Z CODES

    Hi everyone ! need some guidance...... I code facility ED records and i am having a hard time interpreting the guidelines correctly for reporting the Zcodes for exposure to Novel 2019 Corona Virus. It appears to me that both Z20.828 and Z03.818 require that testing be done (labwork) in order to...
  25. A

    Wiki U0002 vs 87635

    Hello Can anyone guide me to the info or explain the difference between U0002 and 87635? Also are these codes only used by the laboratories such as Quest and LabCorp?
  26. B

    Wiki Billing for professional Covid-19 IGM/IGG rapid testing

    Hello, our Ob/Gyn office ordered the Covid-19 IgM/IgG rapid test kit (finger prick test). We inquired to the manufacturer as to how our office would bill for these and we were not given a clear answer. Our physician will administer the test and read it after 10 minutes. Does anyone know how...
  27. L

    Wiki COVID-19 rapid testing

    Does anyone know what code is being used for the new Abbot 5 min. Covid-19 testing?
  28. S

    Wiki Who is responsible for indicating U07.1 diagnosis? The laboratory or the ordering healthcare provider?

    An ordering provider sends COVID-19 testing to an independent laboratory. The results are positive. The independent laboratory bills insurance. Should they use the diagnosis codes provided by the ordering provider or update the diagnosis based on the results of the COVID-19 test?
  29. K

    Wiki Telehealth Scenario - Video to phone

    Hello, Do you know how our providers would code if they are attempting a virtual video visit, but technology fails (video freezing, poor connection, etc.) and the provider has to finish the visit via telephone? I have communicated that the provider would have to use the phone codes at that...
  30. K

    Wiki Telehealth Scenario

    Hello, Do you know how our providers would code if they are attempting a virtual video visit, but technology fails (video freezing, poor connection, etc.) and the provider has to finish the visit via telephone? I have communicated that the provider would have to use the phone codes at...
  31. Z


    We are an Infectious Disease group. The doctors see patients at the hospital. Due to the supply shortages (protective equipment and testing kits) at the hospitals in NYS at the moment some visits with the patients being seen for COVID-19 r/o are not able to undergo a proper physical. The doctors...