Author Topic: Covid testing  (Read 140 times)

stellerdobes

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Covid testing
« on: November 10, 2020, 12:47:06 PM »
Anyone billing for a drs office that is doing
Covid testing?   If so would you share the
codes your using and reimbursement

Michele

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Re: Covid testing
« Reply #1 on: November 11, 2020, 01:33:39 PM »
We have not started yet, but we have an office that is getting ready to start.  I would be interested to know what others are experiencing as well.
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RichardP

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Re: Covid testing
« Reply #2 on: November 17, 2020, 01:59:32 PM »
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.pdf

2.  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-guidance
https://www.fda.gov/consumers/consumer-updates/coronavirus-disease-2019-testing-basics

Codes:  https://www.cms.gov/files/document/mm11960.pdf

RichardP

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Re: Covid testing
« Reply #3 on: November 17, 2020, 02:10:53 PM »
This link is buried in the AMA link above.  Readers may pass over it, so I will place it here.  Some coding scenarios for providers and patients seeking Covid-19 testing.

https://www.ama-assn.org/system/files/2020-05/covid-19-coding-advice.pdf

Michele

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Re: Covid testing
« Reply #4 on: November 18, 2020, 12:36:57 PM »
Thanks for sharing Richard!  I have to meet with a Dr this Friday and this is exactly what he needs.   :)
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RichardP

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Re: Covid testing
« Reply #5 on: November 18, 2020, 03:12:02 PM »
You are welcome.

I have some other links to add, but probably won't get to it for a few days.  If Dr. is not running a commercial lab, the codes I provided in bold should cover at least the basics of what he might want to do.

stellerdobes

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Re: Covid testing
« Reply #6 on: November 20, 2020, 10:00:01 AM »
Thanks this is the information I needed.