I am currently working in LAB's billing deptt and came to know that CMS and most of the commercial insurances denying CPT code 87632 ( Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 6-11 targets) and CPT code 87633 ( Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 12-25 targets) as non covered charges in 2020. Can someone guide me is there any alternative CPT code which can be use in place of above cpt codes?
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Wiki Non Covered CPT Code 87632-87633 Respiratory Panel in 2020
- Thread starter hraza
- Start date
SharonCollachi
Guest
There have been coding changes this year, including some new U-codes. For instance: https://www.cms.gov/files/document/covid-ifc-2-flu-rsv-codes.pdf
This document is not too much helpful.. can you please guide me further.
SharonCollachi
Guest
Okay, going back to your question, you said they were "non-covered." Non-covered for that diagnosis? Non-covered for that frequency of tests? Non-covered for what, exactly? What are the denials telling you?
Are you testing for Covid? Is what you are doing for 86732 match what is now described under U0004?
Are you testing for Covid? Is what you are doing for 86732 match what is now described under U0004?
Yes, we are performing cpt code 87632 with Covid diagnosis code U07.1. and per CMS these CPT codes are non-covered in 2020 this year. Can we use U0004 in place of 87632, 87633 or any other cpt code.
SharonCollachi
Guest
The U codes are for COVID tests, yes. You have to determine which code matches your specific test method. I would show the document I linked to your lab manager or someone who knows which specific method you are using, and ask them to choose one of the U codes.