tbecker
Contributor
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?
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Wiki Rapid Covid Testing
- Thread starter tbecker
- Start date
remarkha
New
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
Guru
we are using 87426 but not sure about reimbursements yet,
njycarter17
Networker
We are also using 87426 and 87426-QW (Medicare), but not sure about the reimbursements yet either.
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.
Peace
@_*
Hope that helps. Here is a sample reimbursement policy from another insurance company.
klapetri@ilovemygyn.com
Guest
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
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
New
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?