Wiki In office Covid testing

[SueLis]

We are going to start Covid testing in our office with nasal probe and rapid system for screening our pt's for prior to their surgery in our office. We were informed by McKesson to use CPT code 87426 along with low level office visit and my provider also wants to use U0003 also since we are collecting and doing reading. Which I though U0003 was for Laboratory billing and not sure if this needs to be billed to Medicare instead of 87426? I have looked at a lot of CMS articles and can't find a clear answer. Is anyone using this test or familiar with this billing?

 

[mihill]

We are considering the same scenario, pre-surgical Antigen testing using CPT 87426 but doing the test same day in our ASC. Patients are asymptomatic. Lots of CMS articles, no clear answers.

 

[csperoni]

I don't bill labs or COVID testing, but the descriptions of 87426 and U0003 are different, depending on how the test is performed (differences in bold):

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])

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.
Either of these would be for performing the actual test, depending on the method used. Unless you are performing 2 separate tests, you would not be able to bill for both. I do not know the CLIA requirements of either. I would assume (big assumption) that the company selling you the tests has appropriate knowledge to give you the correct code.

 

[SharonCollachi]

I would assume (big assumption) that the company selling you the tests has appropriate knowledge to give you the correct code.

You would think so. However, the fact that they are saying to bill the office visit and the test is worrisome.

 

[SueLis]

I am trying out 99212 w/dx Z01.812 and 87426 w/dx Z20.828 which is being done 1 day prior to in office procedure and they being evaluated by a provider for the 99212.