COVID-19 cases are surging across the country as the US heads into holiday season. Counsel patients on staying safe and keep these billing codes very close at hand.
As numbers of COVID-19 cases reach new all-time highs in rural, suburban, and urban locales, healthcare practitioners again face the stress of assessing, diagnosing, and treating not just the SARS-CoV-2 virus, but now other seasonal circulating viruses as well.
In a recent Quick Tips and Insights newsletter, the American Academy of Family Physicians culled the 6 most important codes you'll need to bill accurately for the many different services you'll be providing. Here they are, at a glance.
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UO7.1, COVID-1. This is the diagnosis code for all cases of COVID-19, whether it’s diagnosed based on testing * symptoms * exposure or any combination of the three.
Z20.828 Contact with and (suspected) exposure to other viral communicable diseases. Use this code when you think a patient has been exposed to the novel coronavirus, but you’re uncertain about whether to diagnose COVID-19 (ie, test results are not available).
It should be accompanied by codes for the patient’s symptoms, if there are any.
B94.8 Sequelae of other specified infectious and parasitic diseases. Use this code for patients who are still suffering from COVID-19 complications after clearing the initial infection.
It should be combined with other diagnosis codes for the patient’s ongoing symptoms.
CPT 87426. Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay, enzyme- linked immunosorbent assay, fluorescence immunoassay, immunochemiluminometric assay), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2).
*This recently revised code is for administering an antigen test, which is quicker/simpler than other tests for COVID-19 and therefore is more likely to be done at the point of care.*
CPT 86328. Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); SARS-CoV-2 (COVID-19).
This is the code for a single-step test to identify antibodies in patients previously or currently infected with the novel coronavirus.
CPT 87637. Infectious agent detection by nucleic acid (DNA or RNA); SARS-CoV-2, influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique.
This is a new code for a single genetic test that can identify COVID-19, the seasonal flu, or respiratory syncytial virus. (For tests that combine only COVID-19 and the flu, report 87636.)