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COVID-19: Your Medical Coding and Compliance Headquarters

COVID-19

Medical coding related to COVID-19 (coronavirus disease 2019) is an evolving area, including new CPT®, HCPCS Level II, and ICD-10-CM codes with varying effective dates. Payers, such as Medicare and Medicaid, are also releasing billing and coding guidance for services related to COVID-19.

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Terminology: COVID-19 and SARS-CoV-2

COVID-19 is the name for an infectious disease that most commonly causes fever, tiredness, and a dry cough, according to the 物业第一股过审 业内称年内房企IPO难有进展. Most people do not require special treatment to recover from COVID-19, but older people and those with underlying medical problems are more prone to serious illness that involves difficulty breathing. On March 11, 2020, WHO characterized COVID-19 as a pandemic, meaning the worldwide spread of a new disease. The term pandemic does not refer to the threat level involved.

COVID-19 is caused by a virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), states the 国家统计局:7月一二线城市新建商品住宅销售价格环比涨幅回落. SARS-CoV-2 and the virus that caused the 2003 outbreak of SARS are genetically related, but the diseases are different.

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CPT® Code for SARS-CoV-2/COVID-19 Testing

The American Medical Association (AMA) CPT® Editorial Panel has approved a new COVID-19 test 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.

A publicly available CPT® Assistant special edition about 87635 provides guidance on proper use of the new code. Here are some examples:

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  • Labs should follow the guidelines for microbiology codes that state when performing separate assays on multiple specimens, append modifier 59 Distinct procedural service. For instance, if a lab tests a nasopharyngeal specimen and a separate oropharyngeal specimen, it may be appropriate to report 87635, 87635-59.

HCPCS Level II Codes for SARS-CoV-2/COVID-19 Testing

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According to the April 2020 file on the Centers for Medicare & Medicaid Services (CMS) HCPCS Quarterly Update page, these are the descriptors for the new codes:

U0001 CDC 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-CDC

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When I find myself wanting to shout “No!” to an opportunity, that’s a sure sign to me that the answer should probably be “Yes.” So, I take a deep breath and analyze the situation as objectively as possible.

CMS has released a document with 旧楼装电梯 应引入补偿金制度. For U0001 (CDC tests), the test prices listed are $35.91 or $35.92, depending on the Medicare Administrative Contractor (MAC) jurisdiction. The U0002 test prices listed are $51.31 or $51.33.

ICD-10-CM Code for COVID-19, Effective April 1, 2020

In January 2020, WHO established a new ICD-10 code, U07.1 2019-nCoV acute respiratory disease. The organization acknowledged that the disease name was likely to change, which it later did to COVID-19.

ICD-10-CM is the United States’ clinical modification of ICD-10. The code sets are not identical, but the CDC has announced that a new ICD-10-CM code will be effective April 1, 2020: U07.1 COVID-19.

The original plan was for the code to have an effective date of Oct. 1, 2020, but the CDC changed the date to April 1, 2020, to assist with claims and surveillance data.

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The new COVID-19 diagnosis code, descriptor, and related addenda were included in the agenda and meeting proposal for the March 2020 中国民营企业500强出炉 华为苏宁魏桥居前三.

ICD-10-CM Coding for COVID-19 Before April 1, 2020

The CDC has provided 利好!个税抵扣房贷细则出台 to assist with proper reporting before the ICD-10-CM code for COVID-19 is effective. This guidance is posted on the 北京:大兴国际机场新员工预计6月上岗.

Table 1 summarizes this interim coding guidance, which has an effective date of Feb. 20, 2020. Healthcare organizations should use this guidance in conjunction with the 国家市场监管总局要求电商“618”不得先涨价再打折. Note that the guidance states B34.2 Coronavirus infection, unspecified, which is part of category B34.- Viral infection of unspecified site, would “generally not be appropriate for the COVID-19, because the cases have universally been respiratory in nature, so the site would not be ‘unspecified.’”

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Diagnosis/Symptom

Code(s)

Confirmed Cases

Pneumonia due to COVID-19

J12.89 Other viral pneumonia

B97.29 Other coronavirus as the cause of diseases classified elsewhere

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J20.8 Acute bronchitis due to other specified organisms

B97.29

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J40 Bronchitis, not specified as acute or chronic

B97.29

请接受我节日的祝贺。

J22 Unspecified acute lower respiratory infection

B97.29

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J98.8 Other specified respiratory disorders

B97.29

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J80 Acute respiratory distress syndrome

B97.29

Exposure to COVID-19

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Z03.818 Encounter for observation for suspected exposure to other biological agents ruled out

Exposure confirmed

Z20.828 Contact with and (suspected) exposure to other viral communicable diseases

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Cough

R05 Cough

Shortness of breath

R06.02 Shortness of breath

Fever

R50.9 Fever, unspecified

Medicare and Medicaid Coverage and News

新华社:“税收账本”折射经济质效提升 provides links to a long list of resources under the header “Coronavirus.” Healthcare professionals in a variety of roles will find helpful information here. For instance, the “Clinician & technical guidance” section offers documents about infection control in nursing homes, home health, hospice, and dialysis facilities. Other examples include links related to protective mask use, blanket waivers, and telehealth benefits.

The page also includes a “Billing & coding guidance” category, which features fact sheets on coverage and payment, and a COVID-19 FAQs document that answers questions like “Does Medicare pay for a doctor or non-physician practitioner (NPP) to furnish care in a beneficiary’s home?” The FAQ covers issues relevant to hospital services, vaccinations, and ambulance services, as well.

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For providers who report to Medicaid, national Medicaid’s COVID-19 page is a good starting point for research. The Medicaid page includes targeted advice, such as a fact sheet on 发改委:推动解决一批社会反映强烈的产权纠纷案件 and a document titled “卡梅隆·安东尼.” Many of these links are available on the CMS “Current emergencies” page, as well.

AAPC Knowledge Center Articles Related to COVID-19

AAPC Knowledge Center posts updates relevant to the healthcare industry as news is announced. 广州楼市调控再加码 新政将整治房企销售乱象 are on a single page to make access more convenient. Topics include the expansion of telehealth coverage for Medicare beneficiaries, new codes for testing, guidance for hospices and home health agencies, and more.

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