She knows what questions need answers and developed this resource to answer those questions. For individuals in a SNF or for individuals whose samples will be collected by a laboratory on behalf of an HHA, the fee will be $25.46. The following specimen collection guidelines follow standard recommended procedures. Answer: The appropriate code to be reported is Supplies ; Instructions by Specimen Type ; Microbiology Culture Tests ; . http://www.cms.gov/files/document/03092020-covid-19- Question: Can C9803 be billed when the patient comes to an outpatient hospital department and is observed by trained personnel while they self-collect a specimen for COVID testing? %%EOF 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 . Either CPT U0002 or 87635? There is no separate Medicare payment for the collection of the sample for the test. (MLN Connects June 18, 2020). *$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. For CHHA use only. Ic CodingIntel was founded by consultant and coding expert Betsy Nicoletti. Updated May 5, 2021 . Copyright 2023, AAPC The current CPT codes are not appropriate for COVID vaccination, and the 2021 codes may not be in the system. 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. Visit the COVID-19 CPT vaccine and immunization codes page for more information and to download the files. 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. My understanding is the use of CPT code 99211 is being retired with the new E/M coding guidelines going into effect 1/1/21. Can a PCP office bill for a Rapid Detection SARS CoV-2? HCPCS code G2024: Specimen collection for COVID19 from an individual in a skilled nursing facility or by a . COVID-19 research and guidelines for labs and laboratory workers. 237 0 obj <>/Encrypt 215 0 R/Filter/FlateDecode/ID[<75989C3348299A4AA54869724C868AC4><93F59F8A5A95D54F9FF32F74EA23353A>]/Index[214 38]/Info 213 0 R/Length 112/Prev 233903/Root 216 0 R/Size 252/Type/XRef/W[1 3 1]>>stream hb```, cb [jo0.J-=B0 6X`!3![{vww7 fq~Zz/Ou'5 testing code. 559 0 obj <> endobj CMSs 4/30/2020 rule states that practices could bill 99211 for new or established patients during the public health emergency for COVID-19 specimen collection. Earn CEUs and the respect of your peers. COVID-19 Information for Health First Colorado and CHP+ Providers and Guidance for COVID-19 Collection and Testing Sites - California Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) 2021). (CPT) codes should be used for COVID-19 testing? C9803 Hospital outpatient clinic visit specimen collection for Severe Acute Respiratory Syndrome(sars-cov-2) (Covid-19)any spec $22.99 87426 Infectious agent antigen detection by immunoassay technique (for example, This requirement, enacted in section 3202(b) of the CARES Act, is effective for the duration of the PHE for COVID-19. faqs-508.pdf., CMS sates here https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf PDF Correct Coding for COVID-19 Specimen Collection Services - EmblemHealth December 30, 2021. If an E&M service is not provided, 99001 can be used for pop-up labs or specimen collection (MLN Connects May 7, 2020). For specimen collection use *99000, *99001 or G2023. 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 Description. what is the correct code to use for the COLLECTION of the COVID 19 test. 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. 490 0 obj <>stream What code can the PCP bill? Hospital outpatient departments should use HCPCS Level II code C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) (coronavirus disease [COVID-19])), any specimen source to be paid for COVID-19 symptom assessment and specimen collection. can be found in the Telehealth procedure codes for COVID-19 document. 0 Urgent care doing curbside covid testing/ eval. (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source Was the sample for the test personally collected hb```f`` Ab@qax H00Ttt|xY@ ``Z 63*J/XOcab=aNsUX`cPd -$YTY$]2&^ 3 Using it consistently will help practices be reliable in their determinations and provide support in payer audits. 1818 0 obj <>stream Hospital outpatient departments should bill for symptom assessment and specimen collection for COVID-19 using HCPCS code C9803. Can a SNF bill Medicare for G2024 if the nurses are the ones doing the swabs? Effective March 9, 2021, MLabs will offer saliva as specimen type for SARS-CoV-2 (COVID-19), PCR (COVID) testing. 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). Copyright 2023 American Academy of Family Physicians. (As of 05/27/2021) . The place of service code for FQHCs is 50. thank you for your response Renee , It was very helpful. Medicare will allow the use of U0002QW and 87635QW for claims submitted by facilities with a valid, current CLIA certificate of waiver with dates of servcie on or after March 20, 2020. CMS Reimbursement FAQs COVID-19 | The National Law Review