COVID-19 Coding Q&A: CPT®, HCPCS, and ICD-10-CM News for Coronavirus Coding

medical coding for COVID-19

A lot of information is appearing very fast about COVID-19 (coronavirus disease 2019), and medical coders have the extra challenge of sorting through the onslaught to find the bits relevant to coding claims related to testing and treatment. This Q&A brings together the latest authoritative news about coding for COVID-19.

Term tip: COVID-19, a respiratory disease, is caused by a virus named SARS-CoV-2. Be alert for references to both terms in coding news updates.

Will CPT® Create a Code Specific to COVID-19 Testing?

On March 10, 2020, the American Medical Association (AMA), which holds copyright in CPT®, announced that the CPT® Editorial Panel will hold a special meeting to consider a unique CPT® code for reporting novel coronavirus tests. More information should be available from the CPT® Editorial Panel soon.

Is There a HCPCS Level II Code for Testing?

There are two HCPCS Level II codes on the way, according to Medicare’s “Current emergencies” page. The Medicare claims processing systems will be able to accept the codes April 1, 2020, but dates of service can go back to Feb. 4, 2020.

Code U0001 (CDC 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel) will be used specifically for Centers for Disease Control & Prevention (CDC) testing laboratories to test patients for SARS-CoV-2.

Code U0002 (2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-CDC) will allow labs to bill for non-CDC lab tests.

Where Can I Learn More About Medicare Coverage and News?

The “Current emergencies” page, linked in the previous question, is a good place to start. For instance, Medicare has posted a COVID-19 FAQs document on that page that answers questions like “Does Medicare pay for a doctor or non-physician practitioner (NPP) to furnish care in a beneficiary’s home?” and “Does Medicare pay for a doctor, NPP, or nurse to call or use other technology to communicate with a patient?” The FAQ also covers issues like hospital services, vaccinations, and ambulance services.

You also should be sure you’re signed up for email notifications from national Medicare and your Medicare Administrative Contractor (as well as other payers) to get alerts about code updates and policy changes.

Is There an ICD-10-CM Code for COVID-19?

At a January meeting, the World Health Organization (WHO) established a new ICD-10 code, U07.1 (2019-nCoV acute respiratory disease), with the expectation that the virus name would change.

ICD-10-CM is a clinical modification of ICD-10 used in the U.S., so just because ICD-10 has a code doesn’t mean ICD-10-CM will have an identical code. But in this case, the CDC has announced that there will be a similar new code effective Oct. 1, 2020. The new code, descriptor, and relevant addenda are expected to be presented at the March 2020 ICD-10 Coordination and Maintenance Committee meeting.

In the meantime, the CDC has posted an ICD-10-CM Official Coding Guidelines supplement, “Coding encounters related to COVID-19 Coronavirus Outbreak,” to offer authoritative guidance on reporting signs, symptoms, exposure, and confirmed cases.

For future updates on diagnosis coding, keep tabs on the CDC’s National Center for Health Statistics ICD-10-CM page.

What About You?

Do you feel like you’re getting sufficient information related to COVID-19 coding from payers and those responsible for code sets?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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