On Jan. 30, the World Health Organization (WHO) declared the 2019 novel coronavirus (COVID-19) disease outbreak a public health emergency of international concern. The outbreak has since been elevated to a pandemic and President Trump has declared the coronavirus pandemic a national emergency in the United States. Communities across the country are shutting down to limit public gatherings. The goal is to prevent COVID-19 from infecting the masses, for which our healthcare system is not prepared.
In the interim, new procedure and diagnosis codes and associated guidance have been released. Medical coders and billers in all settings must be ready to use these codes.
New CPT® Code
Most recently, the CPT Editorial Panel approved a new Category I Pathology and Laboratory code for novel coronavirus testing. This code is effective March 13, 2020.
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
This is an early release code, so you will need to manually upload this code descriptor into your electronic health record system.
CPT® 87635 will be a child code under parent code 87471 Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, amplified probe technique in the 2021 CPT® code set.
A special edition CPT® Assistant is publicly available, which provides guidance for using this new code.
Visit the AMA website for more information about this new code.
The Centers for Medicare & Medicaid Services (CMS) has released numerous press releases to convey information and guidance to healthcare providers in specific settings. Click here to go to the CMS webpage that contains a compilation of links to all of these resources.
New HCPCS Level II and ICD-10-CM Codes
There are also two new HCPCS Level II testing codes for reporting Medicare beneficiaries being tested for COVID-19, and a new diagnosis code for reporting confirmed cases of COVID-19. It is essential that healthcare systems begin using these codes to report all COVID-19 testing and confirmed diagnoses. This critical data could potentially save the lives of millions.
Renee Dustman, BS, AAPC MACRA Proficient, is an executive editor at AAPC. She holds a Bachelor of Science degree in Media Communications – Journalism. Renee has more than 20 years experience in print production and content management. Follow her on Twitter @dustman_aapc.