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Antibody Covid testing coding for an urgent care?

L

lily899

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Baldwin Park, CA
Hi,

Can you help me confirm if I am using the correct coding for a Covid19 Antibody test. The blood is drawn at the urgent care and sent to the lab. I am coding E/M level plus 36415 and 99000 for the lab specimen handling. As for the Dx I am going with Z03.818 since patients are specifically coming in for that. Your help is greatly appreciated.
 
Per the AHA...

Question: How should an encounter for COVID-19 antibody testing be coded? (4/28/2020)
Answer: For an encounter for antibody testing that is not being performed to confirm a current COVID-19 infection, nor is being performed as a follow-up test after resolution of COVID-19, assign Z01.84-Encounter for antibody response examination.

I would tend to agree with this as Z03.818- Encounter for observation for suspected exposure to other biological agents ruled out is not specific to the antibody testing.

E/M, 36415 and 99000 are correct but as you know, both 36415 and 99000 may not be paid due to payer rules.
 
karamac said:
Per the AHA...

Question: How should an encounter for COVID-19 antibody testing be coded? (4/28/2020)
Answer: For an encounter for antibody testing that is not being performed to confirm a current COVID-19 infection, nor is being performed as a follow-up test after resolution of COVID-19, assign Z01.84-Encounter for antibody response examination.

I would tend to agree with this as Z03.818- Encounter for observation for suspected exposure to other biological agents ruled out is not specific to the antibody testing.

E/M, 36415 and 99000 are correct but as you know, both 36415 and 99000 may not be paid due to payer rules.
Click to expand...

Thank you! I will use the new Dx :)
 
lily899 said:
Hi,

Can you help me confirm if I am using the correct coding for a Covid19 Antibody test. The blood is drawn at the urgent care and sent to the lab. I am coding E/M level plus 36415 and 99000 for the lab specimen handling. As for the Dx I am going with Z03.818 since patients are specifically coming in for that. Your help is greatly appreciated.
Click to expand...


After reading numerous pages and calling our MAC is you are performing the swab collection the code is 99211. If the provider is doing a higher level of of evaluation and management then the collection is inclusive in those codes. The code 99000 is not covered under Medicare in any service location. I also found the attached tip sheet from the AMA. The is also a frequently asked questions from CMS that I am attaching as it does mention Urgent Care Centers
 

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