- AMA Announces New CPT Codes for Coronavirus Testing
- What Providers Need to Know About COVID-19 Coding and Billing
The additional supplies, materials, and clinical staff time the new CPT code covers, according to coding guidance from the AMA, includes patient symptom checks over the phone and upon arrival, donning and removing personal protective equipment (PPE), and increased sanitation measures to prevent the spread of communicable disease.
These are on top of the usual supplies and materials providers use to care for patients.
The code should only be used during a declared public health emergency and is different from code 99070, which is typically reported for supplies and materials that may be used for provided to patients during a normal office visit, the Association also pointed out.
CPT code 99072 should be reported only once per in-person visits per provider identification number (PIN), regardless of the number of services performed during the visit.
AMA also noted that it has submitted recommendations to CMS to “inform payment” of the new CPT code.
Additionally, the latest CPT code set announcement from the AMA included the unveiling of the new CPT code 86413 for the reporting of quantitative measurements of COVID-19 antibodies.
CPT code 86413 expands the code set’s ability to capture the new development of COVID-19 antibody tests.
Previously, the AMA added CPT codes for the development of laboratory tests that provide qualitative assessments of COVID-19 antibodies. In other words, tests that either show the presence of COVID-19 antibodies or not.
The Association has also approved codes for other COVID-19 diagnostic tests, the BioFire® Respiratory Panel 2.1 (RP2.1) test and infectious agent detection by nucleic acid.
The newest COVID-19 test code, however, describes the measuring of antibodies, which can “investigate a person’s adaptive immune response to the virus and help access the effectiveness of treatments used against the infection,” the AMA said in the announcement.
Per the coding guidance released alongside the announcement, the aim of the CPT code 86413 is to aid studies of the epidemiology, pathogenesis, prevention, and treatment of the novel coronavirus.
The new code, and CPT code 99072, were approved by the AMA for immediate use.
“The CPT code set continues to quickly adapt during the COVID-19 pandemic to streamline the reporting of innovative tools and services now available to help reduce the COVID-19 disease burden, improve health outcomes and reduce long-term care costs,” Susan R. Bailey, MD, president of the AMA, stated in the announcement. “This update is the latest in a series of modifications to the CPT codes set to meet the needs of the health care industry as medical advancements expand the fight against COVID-19.”
Coding and billing during the public healthcare emergency has been a major challenge for providers.
In a recent survey conducted through the Healthcare Financial Management Association's (HFMA) Pulse Survey program for Alpha Health, providers agreed that confusion over COVID-19 coding and claim requirements was the top impact the pandemic has had on revenue cycle operations behind erratic claim volumes.
Other impacts included overstaffing due to decreases in claim volumes, decreases in staff productivity due to rapid and unplanned move to working remotely, and decreases in staff productivity due to lay-offs, furloughs, and other staff reductions.
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