Rapid Covid Testing

[tbecker]

Our Pediatric office is looking for the best/correct CPT code to use when performing a Rapid Covid test in our office. We've tried 87635, 87426 and now 87301. Has anyone had success with any of these codes?

 

[remarkha]

I was looking into billing for it also i have read some info where they state they don't coverer the cost of the test. I was seeing the 87426 have you had any luck getting reimbursement

 

[jbhuju]

we are using 87426 but not sure about reimbursements yet,

 

[njycarter17]

We are also using 87426 and 87426-QW (Medicare), but not sure about the reimbursements yet either.

 

[daedolos]

Per Anthem BC PPO, in Southern California, cpt 87426 generally is charged $55 but allowable is generally around $24. The variance is due to contractual agreements.

Peace
@_*
Hope that helps. Here is a sample reimbursement policy from another insurance company.

https://www.medica.com/-/media/documents/provider/covid-19-testing.pdf?la=en&hash=ADA9836AB9582B58D07613220B641038

 

[klapetri@ilovemygyn.com]

OBGYN office

We are billing 87636-Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex amplified probe technique

87636
pos 11(office)
no e/m
no modifier

Receiving payments from most payors. So far we have not receive payment from Oxford , EmblemHealth HIP/GHI

Any suggestions?
Appreciate the feedback

 

[latonya1730]

we are charging the 87636, and the patient is asymptomatic, but exposure to Covid-19. and yet there are denial for the L37348 associated dx code. if they are asymptomatic why would there need to be another dx code?