Wiki Return to School/sports covid testing

[gchmelewski]

I have patients coming into the office for the following.

they are asked by the school to get covid test before coming. (another example is to be able to participate in dance recital) they come to our office for a test. no signs or symptoms.

I was coding these with the administrative code as primary now these diagnosis are denying as non covered. Z02.5 or z02.0 as primary. I want to make sure I am coding correctly. I do know that they would not pay cost share waiver for these types of visits but I don't understand why they are denying visit all together. It doesn't make sense that you can drive up get free test done but insurance won't cover the visit.


The second type of visits would be for patient's that did have covid and now they must return to us to also get clearance to return to school . Sometimes a covid test might be run and sometimes they are not based on the patient. I was coding these the same way as above.

Is there a better way to code these? Are we just out of luck on these visits and will have to eat the costs?

 

[thranowski]

If they are just coming for testing and not seeing the provider, CMS approved 99211 for nurses/MAs performing the COVID test and delivering results, you just have to document properly. During a PHE, the appropriate ICD10 to use is Z20.822 Contact with and (suspected) exposure to COVID-19 (if they are negative), because everyone is possibly exposed at any time. Once the PHE ends, then we can use the Z11.52 Screening for COVID-19 when appropriate.

When they return for a follow up, the appropriate codes to use are Z86.16 Personal history of COVID-19 and Z09 Encounter for w/u exam after completed treatment for conditions other than malignant neoplasm (so long as if they test again, the test is negative). If they get another test, I code Z20.822 as well. However, at our office since the CDC does not recommend retesting, we do not do it unless deemed necessary by the doctor.