Over the last several months, the COVID-19 Pandemic has changed the course of the medical industry and The American Medical Association has approved new CPT codes for use during the COVID-19 public health emergency. Two new Category I CPT Codes were announced on September 8, 2020 for immediate use to meet the rapidly changing needs of the healthcare industry.
Special Services, Procedures & Reports Code
99072 – Additional supplied, materials and clinical staff time over and above those usually included in an office visit or other non-facility service(s) when performed during a Public Health Emergency as defined by law, due to a respiratory-transmitted infections disease.
CPT Code 99072 covers additional supplies, materials and clinical staff necessary to support safe in-person interactions with providers or other healthcare professionals during the COVID-19 pandemic. This code became effective September 8 and will expire on October 25, unless extended. According to 1CPT Assistant, 99072 should only be used when safety measures surpass the usual and customary services provided during an office visit. Supplies, material and clinical staff used during a typical office visit should be coded as 99070.
There are four additional guidelines that should be reviewed and utilized when using code 99072:
- The time counted in any other time-based visit or service during the same encounter cannot be counted twice to report this code.
- You do not need to link the code to a particular diagnosis code.
- You may report 99072 with an evaluation and management (E/M) service or procedure even if it is not public health emergency related
- You may report 99072 only once per in-person patient encounter
Pathology & Lab Code
86413 – Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative
During the continued development of laboratory tests that measure the quantitative levels of COVID-19 antibodies, CPT Code 86413 was introduced and approved for use. When this method of testing is performed, a person’s immune response to the virus can be measured and studied to assist with the effectiveness of treatment methods used against the Coronavirus.
4 New Coronavirus-Related Codes Approved for 2021 Code Set
Coronavirus Antibody Testing is used to determine if a patient has been exposed to or infected by the COVID-19 virus. This is done by verifying whether their body has created the antibodies to assist in fighting the infection, regardless of whether or not the patient was symptomatic. The next step in the fight against this Public Health Emergency is to determine what patients have these antibodies. While the science moves forward in developing new tests and procedures, the American Medical Association has had to establish new CPT Codes to report these tests. Several new codes have already been published for use and several others have recently been approved.
Code 87635 is used to report infectious agent detection by nucleic acid (DNA or RNA); SARS-CoV-2 (Coronavirus disease [COVID-19]), amplified probe technique. Code 86318 was developed as a parent code to 86328. While 86328 is used to report a single-step antibody test for SARS-CoV-2, it’s new parent code (86318) is used to report immunoassay for infectious agent antibodies. Code 86769 is used to report multiple-step antibody testing for SARS-CoV-2 and PLA code 0202U is used to report the BioFire® Respiratory Panel 2.1 (PR2.1) test.
1 https://www.ama-assn.org/practice-management/cpt/covid-19-coding-and-guidance
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