We have been doing C19 testing since it became possible to do. We bill testing done in a sophisticated Physician Office Lab (POL) as well as testing that is sent out to an off-site lab. There is much information involved. I will gather links and post them here as I get them.
But first,
stellerdobes, it is important to know whether you need codes for the collection of a specimen that will be sent to an outside lab, or whether you have a POL which will do the testing in-house. There are different codes for each.
Here are a few points, most without links to the verication documents for now:
1. There is to be no charge to the patient for Covid-19 testing. For those with insurance, billing is to be insurance only. For those without insurance, other options are available (no link at the moment). Practical implication is that provider can charge whatever he wants. He is only going to get what the insurance pays. May not balance bill the patient. See Questions 1 and 2 at the following link:
https://www.cms.gov/files/document/FFCRA-Part-42-FAQs.pdf2. If patient comes in ONLY for collection of specimen(s) to be sent to lab (POL or outside), it is appropriate to bill CPT Code
99211 for that effort. This assumes that testing is not being conducted as part of an office visit for other issues.
3. Diagnosis Code for any Covid-19-related testing is
Z03.818.
4. Lab test for
current infection: CPT
87426 - Viral tests - PCR tests and antigen tests (nasal swab) are both diagnostic tests, which means that they can be used to determine whether you currently have an active coronavirus infection.
5. Lab test for
previous infection: CPT
86328 - antibody tests (blood draw)
6. CPT Code for covering the costs of incidental supplies is
99072 (PPE; cleaning supplies; clinical staff; etc)
More later as I figure out the better links to post. For now, you can scroll through these as time allows.
https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-coding-and-guidancehttps://www.fda.gov/consumers/consumer-updates/coronavirus-disease-2019-testing-basicsCodes:
https://www.cms.gov/files/document/mm11960.pdf