Question Pre-surgical Covid Testing

SSummCCH

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Hello. I am in Nebraska and I thought I read somewhere that the commercial plans and Medicare are not going to be covering pre-surgical testing for Covid. Has anyone else heard or read this anywhere?
 

csperoni

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I certainly have not heard of this. In fact, NYS regulations REQUIRES a negative COVID test within 5 days of a planned non-emergency procedure in a hospital. This has been since end of April, when elective procedures resumed.
 

DGDONNA

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Do you know what diagnosis code to use for pre op screen for Medicare, they rejected my claims using z11.59. Any help would be appreciated.
 

thomas7331

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Do you know what diagnosis code to use for pre op screen for Medicare, they rejected my claims using z11.59. Any help would be appreciated.

Per the AHA:

During the COVID-19 pandemic, a screening code is generally not appropriate. For encounters for COVID-19 testing, including preoperative testing, code as exposure to COVID-19 (code Z20.828).

For an encounter for COVID-19 testing being performed as part of preoperative testing, assign code Z01.812, Encounter for preprocedural laboratory examination, as the first-listed diagnosis and assign code Z20.828 as an additional diagnosis.


 

csperoni

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As I was looking through my notes for the answer, Thomas swooped in.
Yes, ICD10 is Z01.812 primary, Z20.828 secondary

See question #38 https://www.codingclinicadvisor.com/sites/default/files/Frequently Asked Questions Regarding COVID-19_v12.pdf
Question: How should an encounter for screening for COVID-19 be coded, such as a patient being tested for COVID-19 as part of preoperative testing? Should code Z11.59, Encounter for screening for other viral diseases be assigned? (8/5/2020)Answer: During the COVID-19 pandemic, a screening code is generally not appropriate. For encounters for COVID-19 testing, including preoperative testing, code as exposure to COVID-19 (code Z20.828).For an encounter for COVID-19 testing being performed as part of preoperative testing, assign code Z01.812, Encounter for preprocedural laboratory examination, as the first-listed diagnosis and assign code Z20.828 as an additional diagnosis.Note: This advice is consistent with the updated ICD-10-CM Official Guidelines for Coding and Reportingthat become effective October 1, 2020. During these unprecedented times, AHA and AHIMA concluded it was necessary to clarify the appropriate codes for COVID-19 testing in advance of the effective date for the revised official coding guidelines
 
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