In an interim final rule related to COVID-19 policy and regulatory revisions, the Centers for Medicare & Medicaid Services (CMS) explains that tests that allow patients to collect the specimen would not be eligible for the specimen collection fee. She holds a Bachelor of Science degree in Media Communications - Journalism. S%!oP\O&%|T) y( ?I 6l >`s1^H;NPy>JDO,d{d7&;X@wH=]. endstream endobj startxref Coadministration of Routine Vaccines with COVID-19 Vaccines and CPT Code 90697 Now Available - 08-30-2021; COVID-19 Third Dose Vaccine - 08-23-2021 . The current CPT codes are not appropriate for COVID vaccination, and the 2021 codes may not be in the system. C9803. These fees and expenses are not billable if the patient collects their own specimen and a messenger service picks it up. vY5 r,"bA*TXVs H2JyE*$X%[0;L:i Rz@L*`$x2@ H& Plasma from a PPT capacity be frozen and shipped in situ. These are not for use by medical practices. up|q5fx=zmpkq~rFKs-;e1[Z{23f@Qor?8)~-750p40*ut }($2 B@Q 60x 9 i @ A%%9 @ See also the CPT Assistant Special Edition April Update for the AMAs guidance on using 86328 and 86769. 2021 icd 10 cm guidelines covid 19 specimen . be included in the CPT 2021 code set in the Microbiology subsection of the Pathology and Laboratory section. Medicare posted these new specimen collection codes in a March 31, 2020, special edition MLN Connects and in a last-minute revision to the April 2020 HCPCS Level II quarterly update file: The specimen collection fee applies if the specimen is collected by trained laboratory personnel from a homebound or non-hospital inpatient and the specimen is a type that would not require only the services of a messenger pick up service. CPT/ HCPCS Code Laboratory Code Long Descriptor Target 1. Regarding specimen collection, please note Medicares response to the question of who can bill: Independent laboratories can bill Medicare through their MAC for the specimen collection fee. G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source testing? Additionally, the AMAs CPT Assistant is providing two fact sheets for coding guidance for the SARS-CoV-2 (COVID-19) test in relation to the use of the new CPT codes. Depending on the nature of the encounter and payer, you may be able to consider an E/M code and/or handling code 99000. See the CPT Assistant Special Edition May Update for more details on how the AMA intends us to use this new code. Editor's note: on June 24, the CPT Editorial Panel approved the addition of a new code for reporting antigen testing, which is designed to be a quicker way to identify patients infected by the novel coronavirus. Check the NCCI edits. I know that specimen collection code 99000 is not paid by most payers, and I understand that collecting this specimen costs practices significantly. Report 86328 once per reagent strip. The effective date for 0202U, per the AMA, is May 20, 2020. The American Medical Association (AMA) released a new proprietary laboratory analysis (PLA) code for novel coronavirus testing. Privacy Policy | Terms & Conditions | Contact Us. Tech & Innovation in Healthcare eNewsletter, FDA Amends COVID-19 Vaccine Emergency Use Authorizations, Unlock the Full Potential of a Medical Coder, Trinity Health Centralizes EHR, Revenue Cycle, https://www.bcbsnd.com/coronavirus/covid-19providers/billing, 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, CDC or non-CDC, making use of highthroughput technologies, completed within 2 calendar days from date of specimen collection, nfectious agent antigen detection by immunoassay technique, (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (e.g, SARS-CoV, SARSCoV-2 [COVID-19]), Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19]) and influenza virus types A and B SD: SARSCOV & INF VIR A&B AG IA, Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected, Antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), includes titer(s), when performed, Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22 targets including severe acute respiratory syndrome coronavirus 2 (SARS-C0V-2) Qualitative RT-PCR, nasopharyngeal swab, each pathogen reported as detected or not detected, Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]); titer, Infectious disease (bacterial or viral respiratory tract infection) pathogen-specific DNA and RNA, 21 targets, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), amplified probe technique, including multiplex reverse transcription for RNA targets, each analyte reported as detected or not detected, Surrogate viral neutralization test (sVNT), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), ELISA, plasma, serum, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative. hb```f`` ~Abl,/&`z` vM:`07y,j*Z&]6BYHo} However, Medicare reimburses providers and laboratories about double the rate for the codes (U0003 and U0004). Im looking for specific guidance. This requirement, enacted in section 3202(b) of the CARES Act, is effective for the duration of the PHE for COVID-19. Proper specimen collection and handling are critical for all COVID-19 testing, including those tests performed in point-of-care settings. If so, what codes would I use? As a reminder, COVID-19 specimen collection is reimbursed as a separate service only (MLN Connects June 18, 2020). what is the correct code to use for the COLLECTION of the COVID 19 test. With the new testing sites that have point of service equipment to detect the COVID virus do you know if POS code 17 can be used to report and receive reimbursement for the test? COVID-19 Testing and Specimen Collection at Pharmacies As of 12/16/2021 Updates are highlighted The following guidance shall continue to remain in effect in accordance with the Public Readiness and Emergency Preparedness Act (PREP Act) for licensed pharmacists to: order COVID-19 tests, approved by the Food and Drug Administration (FDA), to http://www.cms.gov/files/document/03092020-covid-19- 1818 0 obj <>stream multiple specimens, modifier 59 should be used to All Rights Reserved. Can the medical office use G2023 for the collection of the specimen being sent to LabCorp? 559 0 obj <> endobj Clinics should bill the codes outlined in this guidance via the ordered ambulatory fee schedule. Lastly, the Centers for Medicare & Medicaid Services first issued new HCPCS codes for COVID-19 testing last month, and has since added more codes released last week. %PDF-1.6 % endstream endobj startxref . Check NCCI edits. Not sure you can unbundle those codes. *$35.92 in MAC A/B JH, JL, JN, JS, J8, J15, Update: CMS added the QW modifier to HCPCS Level II U0002 and CPT 87635. The MAC adjudicates the FFS claim at physician fee schedule reimbursement. December 30, 2021. Earn CEUs and the respect of your peers. The reference to any specimen source also may allow you to continue to use these collection codes as the industry develops new COVID-19 tests that use different specimen sources. (As of 01/21/2021) . All rights reserved. Testing may also be used for screening and determining the length of a . Independent labs may bill Medicare for specimen collection fees, transportation fees, and personnel expenses for the duration of the PHE for COVID-19. The two HCPCS codes carry a higher Medicare . %PDF-1.6 % UPDATE:Contact your Medicare Administrative Contractor if you did not include modifier CS when you submitted 99211 so they can reopen and reprocess the claim. Renee, FQHCs bill split claims to Medicare/Medicaid payers with non-FQHC services (such as labs, x-rays, etc) billing on the FFS claim with POS 11. testing for the duration of the PHE for the COVID-19 pandemic. those residents in Medicare-covered stays (whose bundled lab tests would be covered A specimen that is not collected correctly may lead to false or inconclusive test results. Refer to SPECIAL BULLETIN COVID-19 #151: Laboratory Codes for COVID-19 Testing. office manager or physician? . Also, coding for prolonged care services gets another overhaul with revised codes and guidelines. Renee has more than 30 years' experience in journalistic reporting, print production, graphic design, and content management. CHHAs providing specimen collection for homebound patients may bill rate code "4921" and rate code "4922" (travel each way) if specimen collection is the only service performed. 2021 Jun 25;7(2). HCPCS Level II specimen collection codes G2023 and G2024 aren't the only recent additions related to COVID-19. The new code and long descripter is "87426: Infectious agent antigen detection by immunoassay technique, (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID-19]).". The guidance below addresses options for collecting specimens. specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])), any specimen source retroactive to March 1, 2020. . Two new HCPCS Level II codes were created for specimen collection, effective March 1, 2020 . Outpatient hospital specimen collection, HCPCS code C9803, is not allowable in the FQHC or RHC setting. (MLN Matters MM11765). . Each point-of-care test has been authorized for use with certain specimen types and should only be used with those specimen types. 214 0 obj <> endobj Thanks, So i see alot of medicare denials with 99203, 99214 with mod CS and a z code for the dx why is that ? She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. For use by hospital outpatient departments and physician offices: Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) any specimen source G2023. 0 Thank you. Yes, labs can bill specimen collections, as well as a travel allowance (P9603/P9604) for homebound and non-hospital Part B inpatients, but not for Part A hospital or SNF inpatients. Thanks! In the April rule, CMS notes that in the March rule they changed Medicare payment policies to allow for independent labs to be paid for specimen collection under certain circumstances. Can this specimen collection code G2023 and 87635 be billed on each individual patient samples that we collected in our Lab and also from nursing home.. endstream endobj 560 0 obj <>/Metadata 23 0 R/OCProperties<>/OCGs[578 0 R]>>/Outlines 56 0 R/PageLayout/SinglePage/Pages 557 0 R/StructTreeRoot 69 0 R/Type/Catalog>> endobj 561 0 obj <>/Font<>/Properties<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 562 0 obj <>stream HCPCS Level II specimen collection codes G2023 and G2024 arent the only recent additions related to COVID-19. Answer: The appropriate code to be reported is When identifying infectious agents on primary source specimens using antigen detection by immunoassay with direct optical (i.e., visual) observation, see 87802-87899 . Medicare will pay for COVID-19 testing performed by any entity that is (1) certified by CLIA, (2) licensed under state law to perform lab tests, if required, and (3) enrolled in Medicare as a type . endstream endobj startxref COVID -19 Related Codes . To learn more, view our full privacy policy. All comments are moderated and will be removed if they violate our Terms of Use. Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights," featuring practical, peer-reviewed advice for improving practice, enhancing the patient experience, and developing a rewarding career. a CodingIntel membership, Last revised April 18, 2022 - Betsy Nicoletti Tags: telehealth. Question: Should CPT code 87635, a HCPCS Level II Blood sample collections are reported with CPT code 36415 (Collection of venous blood by venipuncture) or 36416 (Collection of capillary blood specimen, e.g., finger, heel, ear stick). If more than one reagent strip is used, modifier 59 (distinct procedural service) should be appended to the code for the second reagent strip assay to identify two distinct analyses were performed. (02) Telehealth as of Jan. 1, 2021 Specimen collection HCPCS codes: G2023 and G2024 Cost share will be waived for COVID-19-specific specimen collection. Im not sure you can unbundle those codes. instead under Part As SNF benefit at 1861(h) of the Act). Anthem is closely monitoring COVID-19 developments and what it means for our customers and our health care provider partners. 631 0 obj <>/Filter/FlateDecode/ID[<8F0CAA201BCE5847AB5A081652A0D9EA><0EC2751726C8A545BED302916B35158C>]/Index[597 76]/Info 596 0 R/Length 147/Prev 446964/Root 598 0 R/Size 673/Type/XRef/W[1 3 1]>>stream Medical office providers can be reimbursed for COVID-19 specimen collection using CPT code 99211 (ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT, TYPICALLY FIVE MINUTES) with modifier CR. Usually, the presenting problem(s) are minimal. ICD-10-CM has also added a new code, U07.1 COVID-19, with official coding guidelines. Deborah Marsh, JD, MA, CPC, CHONC, is a senior development editor at AAPC. 2>m "hpU4tF5"ymYbG\^^ P8c9j| BlY@Z"2. Supplies ; Instructions by Specimen Type ; Microbiology Culture Tests ; . In particular, it will allow providers who can bill for specimen collection codes G2023 and G2024 to bill those codes with modifier CG and receive an additional payment, so long as they meet During the COVID-19 public health emergency, effective with dates of service on or after March 1, 2020, the state plan allowed MO HealthNet to reimburse all providers 100% of the Medicare rate for COVID-19 testing and specimen collection codes. Providers of diagnostic tests for COVID-19 are required to post on their website how much they will charge a patient for the service. Watch this webinar about all these changes. Or can I use this code in place of service 81? Wisconsin. The specimen collection codes listed below are eligible for the IHS (Indian Health Service) encounter rate if rendered *fst|"_yq}Y}Bm[,RWw DO--QhfYiiddVQCG7Ym:`yJg^CXlU=!72!zW*c.rKiQP)VIefc?qZ4MU`\`189?3DpozA%3Uxjfqz\"=p#\=>6P5(8L&HGg!f(VB as specified in California Business and Professions Code section 1288. 672 0 obj <>stream Imran. Just the Latest COVID-19 Codes. Updated: 4/17/20, You will probably find the answers to your questions here: https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf. Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role. For each state, we searched for COVID-19 test prices posted on public websites of the two largest hospitals. we are getting a lot of denials for 99202/99212 and g2023 for our collection or the specimens. 20:iA ?9 Sign up for our monthly newsletter to download the reference sheet. testing code. Some of the tests we result at our hospital outpatient lab and some are sent off to the state, but we do bill for the test (87635 or U0001) as well. To avoid delays by turnaround time when requesting multiple tests up frozen samples, please submit separate frozen specimens to each test . Recorded April Read More All content on CodingIntel is copyright protected. . The Bill for administration of CPT 91303 (Janssen COVID-19 Vaccine) 91302: Centrifuge print within 24 hours of collection. 0 Cost-share will be waived for specimen collection, along with the appropriate ICD-10 code of Z03.818, Z20.828 (effective Feb. 4, 2020) or Z20.822 (effective Jan. 1. They were allowed a small payment for specimen collection during the public health emergency for collection and for associated travel. During the public health emergency (PHE) for COVID-19, CMS has removed the requirement that certain diagnostic tests are covered only under the order of at treating physician or nonphysician practitioner (NPP).

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