Recent updates to coding changes for COVID-19.
Q: Can you please update us on the recent changes for COVID-19?
In addition to the changes that were made at the beginning of 2021, there are several new codes that have been developed by the American Medical Association (AMA) to help facilitate the need for specific COVID-19 testing and services.All of the new codes listed below are effective immediately.
Under the Immunology section of the CPT codebook, a new code 86413 was established to report quantitative antibody detection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2):
New code 99072 was established to report additional practice expenses incurred during a Public Health Emergency (PHE), including supplies and additional clinical staff time.It accounts for additional supplies, materials, and clinical staff time required for patient symptom checks over the phone and upon arrival, the time spent putting on and removing personal protective equipment (PPE), and increased sanitation measures to prevent the spread of communicable disease. The new parenthetical note for 99072 reiterates this information.
Also, 99072 can be billed for an in-person patient encounter (office visit or other non-facility service) when mitigating the transmission of the PHE respiratory disease is required. Use of this code is not dependent on a specific patient diagnosis. Check with your payers to see what documentation they might require to support 99072:
According to the special November edition of the AMA CPT Assistant, a new code was developed a much-needed single test that measures antigens for severe acute respiratory syndrome (SARS) coronavirus (CoV) (eg, SARS-CoV, SARS-CoV-2 [COVID-19]) as well as influenza virus types A and B.This test was given the code 87428, in the Microbiology subsection of the Pathology and Laboratory section of the CPT code set.The AMA made this new code effective immediately.
In October, the AMA also added the following laboratory testing CPT codes for SARS-CoV-2.
Be aware that CPT codes 86317, 87250, 87255 in addition to the new codes listed above have parenthetical notes and guidelines to correct and clarify how to report infectious agent antigen studies.
Additionally, another CPT code was created to use when a provider directly observes the antigen.
There are also revisions made to codes in this section.Note that this clarification only applies to primary source infectious disease codes, and it does not apply to drug testing codes.
All of the changes and additions to this section (new and revised codes) will continue to be valid and active after the Public Health Emergency declaration is lifted.
Renee Dowling is compliance auditor at Sansum Clinic, LLC, in Santa Barbara, California.