Many Primary Care Providers (PCP's) are now able to bill for Covid-19 testing in their office, resulting in no longer having to send patients to outside laboratories or drive-through clinics. Additional CPT codes have been added, making the billing for this a bit harder. Below are the testing codes and a brief explanation for billing them.
The original testing codes are:
86328: Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Coronavirus disease [COVID-19]), effective April 10, 2020
86769: Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), effective April 10, 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, effective March 13, 2020
Added codes are:
87426: Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19]), effective June 25, 2020
86408: SARS-CoV-2 neutralizing antibody screen, effective April 10, 2020
86409: SARS-CoV-2 neutralizing antibody titer, effective April 10, 2020
There are no specific ICD-10 codes that should be used with these CPT's; code the symptoms as they appear. U07.1 should only be used for confirmed cases of COVID-19.
Please note that these codes are not CLIA waived tests (per CMS guidelines, visit here for a list of CLIA waived tests: https://www.cms.gov/Regulations-and-Guidance/Legislation/CLIA/Downloads/waivetbl.pdf) and require your office to have a current, valid CLIA certificate. The CLIA number must be present on the HCFA 1500 claim form in box 23.
If you have questions about coding for COVID-19 testing, or about obtaining a CLIA certificate, please feel free to contact us.
Comentarios