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American Medical Association Releases New CPT® Codes for Coronavirus Disease

Craneware® Insights Regulatory Updates – CWI1225 (15 April 2020)


Topic

American Medical Association Releases New CPT® Codes for Coronavirus Disease

On April 10, 2020, the American Medical Association (AMA) posted information pertaining to revised guidelines and new and revised CPT® codes for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]).

Provider Types Affected

Critical Access Hospitals
Comprehensive Outpatient Rehabilitation Facility
OPPS Hospitals
Provider-Based FQHC
Provider-Based Rural Health Clinics
Physicians

Departments/Areas Affected

Business Office
Compliance / Revenue Integrity
Finance
Laboratory – General
HIM/Medical Records

What You Need to Know

The AMA CPT® Editorial Panel accepted the following new CPT® code, 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 (see Craneware Insights articles #1209 and #1214).

On April 10, 2020, the AMA updated their website to announce guideline revisions, one code revision, and the addition of CPT® codes in response to the COVID-19 pandemic. The CPT® Editorial Panel approved the following revisions and code additions at a special, expedited meeting held, via telephone, on April 10, 2020.

CPT® Code Revision

The AMA revised the following CPT® code, effective April 10, 2020:

86318: Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (eg, reagent strip);

CPT® Code Additions

The AMA added the following new CPT® codes, effective April 10, 2020:

#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]) (please note: “#” indicates the code is not in numeric sequence)

(For severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease {COVID-19}] antibody testing using multiple-step method, use 86769)

86769: Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])

(For severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease {COVID-19}] antibody testing using single step method, use 86328)

The AMA added the following parenthetical note for CPT® code 86635 (Coccidioides):

(For severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease {COVID-19}] antibody testing, see 86328, 86769)

The AMA made the following revision to the guidelines preceding CPT® code 86602 in the CPT® codebook:

The following codes (86602-86804) are qualitative or semiquantitative immunoassays performed by multiple-step methods for the detection of antibodies to infectious agents. For immunoassays by single-step method (eg, reagent strips), use see codes 86313, 86328.

Action Needed

Hospitals and providers should review the CPT® code revisions and additions to determine applicability to their site of service. The facility/provider office should ensure the chargemaster, charge capture tools, and laboratory modules are updated to reflect the above-mentioned changes. Staff who order and bill for these services should be informed of these changes.

Effective Date

10 April 2020

Background

N/A

Reference

https://www.ama-assn.org/practice-management/cpt/covid-19-coding-and-guidance

CPT Codes © 2020 American Medical Association, use of this site denotes acceptance of below terms and conditions

CPT codes, descriptions, and material only are copyright 2020 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained here in. CPT is a trademark of the American Medical Association.

The responsibility for the content of any ‘National Correct Coding Policy’ included in this product is with Centers for Medicare and Medicaid Services, formerly known as Health Care Financing Administration, and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, nonuse or interpretation of information contained in this product.

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.

Applicable FARS/DFARS Restrictions Apply to Government Use.

Current Dental Terminology copyright © 2020 American Dental Association. All rights reserved.

NOTICE: This document contains confidential or proprietary information which may be legally privileged. It is intended only for the named recipient(s) and not to be shared with other facilities or vendors outside of Craneware. Craneware Inc, 3340 Peachtree Road, N.E., Suite 850, Atlanta, GA 30326, Tel: 404-364-2032 email: info@craneware.com