AMA drops CPT Assistant fact sheet on new COVID-19 code

by Richard Scott on Mar 19, 2020

Add another code to your coronavirus testing list. In addition to two available HCPCS codes, you're now eligible to report a new CPT code for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing claims.

Effective March 13, you can turn to the following code:

  • 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)

Along with the new code, the AMA released a special edition of CPT Assistant that offers background information on COVID-19, coding guidance and clinical examples.

"Use of code 87635 will help to efficiently report and track testing services related to SARS-CoV-2 and will streamline the reporting and reimbursement for this test in the United States," the CPT Assistant article states. While you won't find the new code, which the AMA approved after an emergency editorial panel meeting on March 13, in the 2020 CPT code books, the AMA says it will appear in the 2021 books. The coronavirus testing code will appear under parent code 87471.

The AMA makes clarifications on whether providers should turn to the HCPCS codes or the CPT code when testing for the coronavirus. Regarding the HCPCS codes:

  • HCPCS code U0001 is intended for CDC labs.

  • HCPCS code U0002 should be reported by non-CDC public health laboratories.

What about the CPT code? It depends on your payer. Here's what the AMA recommends: "The appropriate code to be reported is dependent upon the payer to which the claim is being submitted. If the claim is submitted to a payer that requires CPT codes, then code 87635 should be reported. Conversely, if the payer requires use of the HCPCS Level II code, the HCPCS Level II code should be reported. CPT and HCPCS codes should not both be reported on the same claim."

For additional guidance on COVID-19 testing, you can access the special edition of CPT Assistant here: https://www.ama-assn.org/system/files/2020-03/cpt-assistant-guide-coronavirus.pdf.

Additional information about the new code is available here: https://www.ama-assn.org/practice-management/cpt/cpt-releases-new-coronavirus-covid-19-code-description-testing.

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