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CMS Releases Two HCPCS Codes for COVID-19 Testing

CMS Releases Two HCPCS Codes for COVID-19 Testing March 10, 2020

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. 

HCPCS
Code
Description
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: 
https://www.cdc.gov/nchs/data/icd/ICD-10-CM-Official-Coding-Gudance-Interim-Advice-coronavirus-feb-20-2020.pdf

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