Covid 19 Testing CPT Codes

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Looking for clarity / clear understanding on the difference between the following 5 CPT Codes for Covid-19 Diagnostic testing. Please and thank you

87635 – Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique

CPT® code 87635 was adopted by the AMA CPT® Editorial Panel during a special session on March 13, 2020 and is available for use on or after that date. This code was established to help report and track testing services related to COVID-19 and to provide reimbursement for COVID-19 testing. Lab tests are evolving rapidly, but 87635 should be used to report testing that is performed using an amplified probe technique. The AMA does note that if tests are performed on two separate specimens, 87635 would be reported twice, appending modifier 59 to the second code to clarify that a separate specimen was tested. Currently, the Centers for Disease Control (CDC) recommends obtaining one specimen from the nasopharynx and a separate specimen from the oropharynx to ensure the most accurate test results. Reimbursement rates for 87635 are currently established at the local level by each Medicare Administrative Contractor (MAC) at either $51.31 or $51.33 depending upon location. Additionally, multiple private payers have followed suit in pricing this drug test at approximately $51.00.

U0001 – CDC 2019 novel Coronavirus (2019-nCoV) real-time RT-PRC diagnostic panel

HCPCS code U0001 was created by CMS on February 4, 2020, and may be used for dates of service on or after that date, although the code was not fully implemented by the MACs until April 1, 2020. U0001 is only to be used for the tests developed by the CDC using the CDC test kit. Laboratories that perform testing using a non-CDC test kit will use either CPT® code 87635 or HCPCS code U0002. Because U0001 uses a test kit obtained from the CDC, there is a lower reimbursement rate associated with this code. Local MACs are currently responsible for developing the payment amount for this HCPCS code, which ranges from $35.91 to $35.92. Multiple commercial payers have also announced their intention to follow CMS’ lead with regards to the reimbursement rate for this code.

U0002 – 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCov (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC

HCPCS code U0002 was also created by CMS on February 4, 2020, and may similarly be used on or after that date. U0002 uses a non-CDC test kit and allows for testing to be done using any technique. Reimbursement for this code is currently at the local level and ranges from $51.31 to $51.33. When deciding which code to assign for COVID-19 testing, CMS recommends using U0001 for CDC tests, 87635 for tests performed using the amplified probe technique, and U0002 for tests performed using other methodologies not described by CPT® code 87635.

U0003 – Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R

HCPCS code U0003 was announced via CMS Ruling CMS-2020-01-R on April 14, 2020, and is available for immediate use. U0003 should identify tests that would otherwise be identified by CPT® code 87635 that are performed using high-throughput technologies such as the Roche cobas® 6800 System, Roche cobas® 8800 System, Abbott m2000 System, Hologic Panther Fusion® System, GeneXpert® Infinity System, and the NeuMoDx 288™ Molecular System. CMS has announced a reimbursement rate of $100 for tests performed using these high-throughput technologies.

U0004 - 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCov (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R

HCPCS code U0004 was also announced via CMS Ruling CMS-2020-01-R on April 14, 2020, and is also available for immediate use. U0004 should identify tests that would otherwise be identified by HCPCS code U0002 that are performed using high-throughput technologies. The reimbursement rate for U0004 is currently $100.
 
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