In response to the widespread outbreak of the 2019-Novel Coronavirus (COVID-19), CMS has released two HCPCS codes for laboratories to report COVID-19 tests.
The following codes will be accepted starting on April 1, 2020 for dates of service on or after February 4, 2020. Currently there is no established national payment rate, therefore local Medicare Administrative Contractors (MACs) are responsible for developing payment amounts.
|U0001||CDC Developed Test SARS-CoV-2/2019 Novel Coronavirus Real Time RT-PCR|
|U0002||Non-CDC Developed Test SARS-CoV-2/2019-nCoV (COVID-19)|
As a reminder, the CDC released Official Coding Guidance for
ICD-10 diagnosis coding as well.
A new, specific ICD-10 diagnosis code will be included in the October 2020 update. However, in the interim, the following guidance should be followed:
|Condition||ICD-10 Diagnosis Codes|
|Pneumonia, confirmed as due to COVID-19||J12.89, B97.29|
|Acute bronchitis, confirmed as due to COVID-19||J20.8, B97.29|
|Bronchitis NOS, confirmed as due to COVID-19||J40, B97.29|
|Acute/lower respiratory infection NOS, confirmed as due to COVID-19||J22, B97.29|
|Respiratory infection NOS, confirmed as due to COVID-19||J98.8, B97.29|
|Acute respiratory distress syndrome, confirmed as due to COVID-19||J80, B97.29|
|Possible exposure to COVID-19, condition ruled-out||Z03.818|
|Exposure to confirmed COVID-19||Z20.828|
Coders should follow the
Official ICD-10 guidelines for guidance on sequencing, reporting signs and
symptoms and reporting conditions stated as “suspected”,
“possible” or probable”.
We recommend providing immediate training to your clinicians regarding proper documentation related to COVID-19. We also recommend updating your charge description masters (CDMs) to include the new HCPCS codes as well as providing immediate training to your laboratory staff, providers and coders regarding proper HCPCS and ICD-10 assignment for encounters related to COVID-19.
To access the CMS Fact Sheet for lab tests, go to: https://www.cms.gov/files/document/03052020-medicare-covid-19-fact-sheet.pdf
To access the complete CDC update, go to: