URGENT Update on Covid 19 Coding & Billing
A new CPT® code has been created that streamlines novel coronavirus testing offered by hospitals, health systems and laboratories in the United States.
The code is effective March 13, 2020 for use as the industry standard for reporting of novel coronavirus tests across the nation’s health care system. Click here…
- 87635 – Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique
Click this CPT Assistant which will provide coding guidelines and FAQs related to the newly developed CPT code.
Please note that, per the standard early release delivery process for CPT codes, hospitals/providers will need to manually upload this code descriptor into your EHR system. This CPT code will arrive as part of the complete CPT code set in the data file for 2021 later this year.
The Centers for Medicare & Medicaid Services has established two Healthcare Common Procedure Coding System codes for coronavirus testing. (News alert). The Medicare claims processing system will be able to accept this code on April 1, 2020 for dates of service on or after February 4, 2020.
- U0001 – 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel using CDC
- U0002 – 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19) using any technique, , multiple types or subtypes (includes all targets)
CMS posted a fact sheet with information related to the pricing for both CDC and non- CDC tests.
For reviewing CMS’s complete coverage and payment related details for all types of treatment Click here…
Physicians and health care organizations should check with local payers to determine their specific reporting guidelines for this new CPT code.
ICD 10 coding for COVID-19
Based on circumstances, either one of the below code can be used.
- B34.2 – Coronavirus infection, unspecified
- B97.29 – Other coronavirus as the cause of diseases classified elsewhere
Examples:
- Patients with COVID-19 may also develop acute respiratory distress syndrome (ARDS), in which case you should choose J80 (Acute respiratory distress syndrome), and B97.29 (Other coronavirus as the cause of diseases classified elsewhere).
- If the patient has bronchitis due to COVID-19, use code J40 (Bronchitis, not specified as acute or chronic), along with code B97.29, (Other coronavirus as the cause of diseases classified elsewhere).
- Use Z20.828 (Contact with and (suspected) exposure to other viral communicable diseases) to document an encounter with a patient infected with any form of the virus and Z03.818 (Encounter for observation for suspected exposure to other biological agents ruled out) if the patient may have been exposed to COVID-19 but that the provider rules out that possibility after evaluation.
Coding tip: “If the provider documents “suspected”, “possible” or “probable” COVID-19, do not assign code B97.29. Assign a code(s) explaining the reason for encounter (such as fever, or Z20.828).
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